Claim total
$838.28
base $93.83 · payer covered $788.28
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-10-25
- Stop
- 2000-10-25
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Jared Berge
- Payer
- payer Medicaid
Record id
0465c17f-66cb-2155-0705-1ac9fa81ce25