Claim total
$505.13
base $93.83 · payer covered $217.70
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-01-17
- Stop
- 2017-01-17
The parties
- Patient
- patient Amalia Ana María Soliz
- Provider
- provider Len Gottlieb
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Medicare
Record id
007eb971-e9c1-129f-5172-6d964472bc16