Claim total
$639.00
base $93.83 · payer covered $639.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-03-06
- Stop
- 2024-03-06
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Anneliese Bradtke
- Payer
- payer Dual Eligible
Record id
0465c17f-66cb-2155-0273-327072b84864