Claim total
$980.65
base $93.83 · payer covered $930.65
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-02-13
- Stop
- 1991-02-13
The parties
- Patient
- patient Soledad Rocio Aguirre
- Provider
- provider Luisa Wilkinson
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Medicaid
Record id
060aa7a8-9653-5ae4-d5ba-b8aea30320d2