Claim total
$229.83
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2023-05-09
- Stop
- 2023-05-09
The parties
- Patient
- patient Nicholas Aron Ferry
- Provider
- provider Jose Pollich
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Humana
Record id
00710614-34f5-5b84-2336-fb84b5a89ea5