Claim total
$15,189.83
base $93.83 · payer covered $12,151.85
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-12-09
- Stop
- 2019-12-09
The parties
- Patient
- patient Maria Dibbert
- Provider
- provider Miguel Ángel Alicea
- Payer
- payer Medicare
Record id
000287f5-a0d8-f77b-5643-8d429a14a2c3