Claim total
$1,407.10
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1993-02-05
- Stop
- 1993-02-05
The parties
- Patient
- patient Guadalupe Andres Mayert
- Provider
- provider Len Gottlieb
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer No insurance
Record id
1710a38f-72a0-b102-3105-b4179a7b7d94