Claim total
$1,136.25
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2015-12-23
- Stop
- 2015-12-23
The parties
- Patient
- patient Santo Booker Denesik
- Provider
- provider Ronnie Gleason
- Payer
- payer UnitedHealthcare
Record id
0cd2f232-7bae-607a-dd03-42688a14b9b1