Claim total
$773.83
base $93.83 · payer covered $619.06
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2023-05-17
- Stop
- 2023-05-17
The parties
- Patient
- patient Ramiro Ramón Uribe
- Provider
- provider Simon Tremblay
- Payer
- payer UnitedHealthcare
Record id
0479f26d-83ad-2793-968a-2e2dfdadc765