Claim total
$293.11
base $93.83 · payer covered $234.48
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2019-07-30
- Stop
- 2019-07-30
The parties
- Patient
- patient Amalia Ana María Soliz
- Provider
- provider Abram Ullrich
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Medicare
Record id
007eb971-e9c1-129f-76af-13055794e7e5