Claim total
$773.83
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2020-10-22
- Stop
- 2020-10-22
The parties
- Patient
- patient Felicitas Lilla White
- Provider
- provider Len Gottlieb
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Cigna Health
Record id
009a994d-1397-364c-b73f-eccc296ccaae