Claim total
$2,623.46
base $155.66 · payer covered $1,153.60
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- —
- Start
- 2024-05-17
- Stop
- 2024-05-17
The parties
- Patient
- patient Terrance Derek Mueller
- Provider
- provider Eldora Denesik
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
032e5f12-51a3-9303-0b02-8909f3e59da7