Claim total
$1,120.62
base $93.83 · payer covered $970.62
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-02-23
- Stop
- 2000-02-23
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-fc91-f06e0ba894b2