Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-07-12
- Stop
- 2004-07-12
The parties
- Patient
- patient Tyron Beahan
- Provider
- provider Tangela Koelpin
- Payer
- payer UnitedHealthcare
Record id
184563ad-94a5-9e2f-b8f1-66b01efab354