Claim total
$701.57
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2015-11-21
- Stop
- 2015-11-21
The parties
- Patient
- patient Johnny Arturo Welch
- Provider
- provider Ursula Nolan
- Payer
- payer UnitedHealthcare
Record id
0ba6ddbb-0755-72b2-392d-2d8b96eddeda