Claim total
$229.83
base $93.83 · payer covered $183.86
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-07-18
- Stop
- 2017-07-18
The parties
- Patient
- patient Amalia Ana María Soliz
- Provider
- provider Luisa Wilkinson
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Medicare
Record id
007eb971-e9c1-129f-3294-48cbf1ebc133