Claim total
$910.06
base $93.83 · payer covered $760.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-10-09
- Stop
- 1991-10-09
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Julene Lemke
- Payer
- payer Medicaid
Record id
0465c17f-66cb-2155-cdf2-b7b9a561d30e