Claim total
$1,190.15
base $93.83 · payer covered $1,190.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-02-12
- Stop
- 2020-02-12
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Anneliese Bradtke
- Payer
- payer Medicaid
Record id
0465c17f-66cb-2155-f59b-021d7121ac73