Claim total
$980.65
base $93.83 · payer covered $930.65
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1965-11-17
- Stop
- 1965-11-17
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Jared Berge
- Payer
- payer Medicaid
Record id
0465c17f-66cb-2155-2f68-574ccd5b1a3a