Claim total
$1,423.88
base $125.00 · payer covered $920.52
The visit
- Class
- Virtual
- Code
- 453131000124105
- Reason
- —
- Start
- 2022-06-22
- Stop
- 2022-06-22
The parties
- Patient
- patient Heriberto Orval Feest
- Provider
- provider Jo Stiedemann
- Payer
- payer UnitedHealthcare
Record id
04dd6dd9-2faa-05da-ac66-470254a3fc0a