Claim total
$505.13
base $93.83 · payer covered $217.70
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2019-11-18
- Stop
- 2019-11-18
The parties
- Patient
- patient Phylis Elenora Cassin
- Provider
- provider Len Gottlieb
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Medicare
Record id
0400c40b-e8b5-c779-44a9-962e3eb31cbc