Claim total
$504.69
base $93.39 · payer covered $403.75
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Dependent drug abuse6525002
- Start
- 2017-09-25
- Stop
- 2017-09-25
The parties
- Patient
- patient Vella Divina Renner
- Provider
- provider Leta Sipes
- Payer
- payer UnitedHealthcare
Record id
02404bb7-0f7d-3a30-648b-844eff1bf84e