Claim total
$11,198.40
base $93.83 · payer covered $8,958.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-01-06
- Stop
- 2025-01-06
The parties
- Patient
- patient Maria Dibbert
- Provider
- provider Miguel Ángel Alicea
- Payer
- payer Medicare
Record id
000287f5-a0d8-f77b-2d6f-6c2fb68c7c29