Claim total
$8,625.60
base $93.83 · payer covered $6,900.47
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-11-10
- Stop
- 2014-11-10
The parties
- Patient
- patient Maria Dibbert
- Provider
- provider Miguel Ángel Alicea
- Payer
- payer Medicare
Record id
000287f5-a0d8-f77b-4085-fa6cd09726ba