Claim total
$1,112.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-07-02
- Stop
- 2021-07-02
The parties
- Patient
- patient Kristin Hortensia Zulauf
- Provider
- provider Roxana Schuppe
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer UnitedHealthcare
Record id
0b7b85ac-350f-06ec-0d5d-923ac2325620