Claim total
$846.78
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-10-22
- Stop
- 2015-10-22
The parties
- Patient
- patient Verona Ginger O'Keefe
- Provider
- provider Rodrick Willms
- Care site
- care site CENTRAL FAMILY CLINIC PLLC
- Payer
- payer UnitedHealthcare
Record id
04161a30-0372-a815-d14b-24e204adf99f