Claim total
$504.69
base $93.39 · payer covered $403.75
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2014-06-23
- Stop
- 2014-06-23
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Pasquale Grimes
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-367c-bb4d924368b5