Claim total
$711.72
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-11-21
- Stop
- 2024-11-21
The parties
- Provider
- provider Venita Fahey
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer UnitedHealthcare
Record id
06444eb9-3bbb-5546-e2ae-3b3248e104f8