Claim total
$157.11
base $93.83 · payer covered $107.11
The visit
- Class
- Wellness
- Code
- 308646001
- Reason
- diagnosis concept Overdose1149222004
- Start
- 2003-11-19
- Stop
- 2003-11-19
The parties
- Patient
- patient Soledad Rocio Aguirre
- Provider
- provider Len Gottlieb
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Medicaid
Record id
060aa7a8-9653-5ae4-2c1b-01f5034c2488