Claim total
$980.65
base $93.83 · payer covered $980.65
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-03-01
- Stop
- 2023-03-01
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Lowell Blick
- Payer
- payer Dual Eligible
Record id
0465c17f-66cb-2155-eb90-5f9036dc1381