Claim total
$2,246.48
base $125.00 · payer covered $2,196.48
The visit
- Class
- Virtual
- Code
- 453131000124105
- Reason
- —
- Start
- 2024-05-19
- Stop
- 2024-05-19
The parties
- Patient
- patient Alyssa Star Feil
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Medicaid
Record id
02cca109-7737-4ad8-3974-f54fdf0a4a1c