Claim total
$773.83
base $93.83 · payer covered $135.20
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2022-12-14
- Stop
- 2022-12-14
The parties
- Patient
- patient Ramiro Ramón Uribe
- Provider
- provider Simon Tremblay
- Payer
- payer UnitedHealthcare
Record id
0479f26d-83ad-2793-c88f-dcdeb937d2bd