Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-07-12
- Stop
- 2018-07-12
The parties
- Patient
- patient Allene Jonell Stark
- Provider
- provider Trisha Gleason
- Payer
- payer UnitedHealthcare
Record id
39bdbcaa-0f4c-539e-b2a3-6de91fb2d0ab