Claim total
$840.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-07-08
- Stop
- 2018-07-08
The parties
- Patient
- patient Terrance Derek Mueller
- Provider
- provider Simon Tremblay
- Payer
- payer UnitedHealthcare
Record id
032e5f12-51a3-9303-1051-13e0f4de0d44