Claim total
$982.78
base $93.83 · payer covered $982.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-07-11
- Stop
- 2018-07-11
The parties
- Provider
- provider Len Gottlieb
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-6fb4-d2150be8199c