Claim total
$838.28
base $93.83 · payer covered $788.28
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1997-02-19
- Stop
- 1997-02-19
The parties
- Patient
- patient Soledad Rocio Aguirre
- Provider
- provider Len Gottlieb
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Medicaid
Record id
060aa7a8-9653-5ae4-7cfc-b06fc2e00f1e