Claim total
$155.66
base $155.66 · payer covered $124.53
The visit
- Class
- Ambulatory
- Code
- 394701000
- Reason
- diagnosis concept Asthma195967001
- Start
- 2023-12-29
- Stop
- 2023-12-29
The parties
- Patient
- patient Heriberto Orval Feest
- Provider
- provider Trinity Mraz
- Payer
- payer UnitedHealthcare
Record id
04dd6dd9-2faa-05da-3c57-bb0fde4eec77