Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-02-11
- Stop
- 2025-02-11
The parties
- Patient
- patient Nanci Lourie Rath
- Provider
- provider Len Gottlieb
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer UnitedHealthcare
Record id
019cb7db-9e62-def9-8e0c-caac14991031