Claim total
$1,046.06
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-11-03
- Stop
- 2016-11-03
The parties
- Provider
- provider Tennille Baumbach
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer UnitedHealthcare
Record id
06444eb9-3bbb-5546-176b-917f7fcbb16b