Claim total
$15,143.85
base $93.83 · payer covered $12,115.07
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-12-20
- Stop
- 2021-12-20
The parties
- Patient
- patient Maria Dibbert
- Provider
- provider Miguel Ángel Alicea
- Payer
- payer Medicare
Record id
000287f5-a0d8-f77b-5feb-de5fd852e6af