Claim total
$1,109.34
base $93.83 · payer covered $1,109.34
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-03-12
- Stop
- 2025-03-12
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Julene Lemke
- Payer
- payer Dual Eligible
Record id
0465c17f-66cb-2155-7a79-2bca7a52bb8a