Claim total
$973.34
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-10-27
- Stop
- 2016-10-27
The parties
- Patient
- patient Carson Kelvin Haag
- Provider
- provider Avery VonRueden
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer UnitedHealthcare
Record id
06937957-309c-6315-3783-8f72261d7075