Claim total
$901.56
base $93.83 · payer covered $901.56
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-12-10
- Stop
- 2008-12-10
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Julene Lemke
- Payer
- payer Dual Eligible
Record id
0465c17f-66cb-2155-2d14-7d1c66319993