Claim total
$1,043.93
base $93.83 · payer covered $1,043.93
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-02-17
- Stop
- 2021-02-17
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Jared Berge
- Payer
- payer Dual Eligible
Record id
0465c17f-66cb-2155-18c0-aab986882598