Claim total
$985.80
base $93.83 · payer covered $985.80
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-09-29
- Stop
- 2021-09-29
The parties
- Provider
- provider Amparo Pouros
- Care site
- care site SENTIENT HEALTHCARE, INC.
- Payer
- payer Medicaid
Record id
1d0b4e6a-bba8-0704-30e3-a1d9374e85f1