Claim total
$639.00
base $93.83 · payer covered $489.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-10-20
- Stop
- 1999-10-20
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Anneliese Bradtke
- Payer
- payer Medicaid
Record id
0465c17f-66cb-2155-6768-e237ba23c933