Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-12-18
- Stop
- 2015-12-18
The parties
- Patient
- patient Melvin Kunde
- Provider
- provider Hazel Effertz
- Payer
- payer UnitedHealthcare
Record id
178a423a-4f3c-4276-f5ca-8b60b4939731