Claim total
$1,052.43
base $93.83 · payer covered $23.93
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2025-08-13
- Stop
- 2025-08-13
The parties
- Patient
- patient Ramiro Ramón Uribe
- Provider
- provider Jared Berge
- Payer
- payer UnitedHealthcare
Record id
0479f26d-83ad-2793-e244-85ea5fbe135c