Claim total
$906.12
base $93.83 · payer covered $756.12
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1961-11-08
- Stop
- 1961-11-08
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Anneliese Bradtke
- Payer
- payer Medicaid
Record id
0465c17f-66cb-2155-5375-bab5a3faff45