Claim total
$5,666.25
base $93.83 · payer covered $4,532.98
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-01-12
- Stop
- 2026-01-12
The parties
- Patient
- patient Maria Dibbert
- Provider
- provider Miguel Ángel Alicea
- Payer
- payer Medicare
Record id
000287f5-a0d8-f77b-a32b-e3871f8d029a