Claim total
$1,356.99
base $93.83 · payer covered $1,356.99
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-02-06
- Stop
- 2019-02-06
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Jared Berge
- Payer
- payer Dual Eligible
Record id
0465c17f-66cb-2155-bf3a-8c4b43dbfc65