Claim total
$773.83
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2025-11-11
- Stop
- 2025-11-11
The parties
- Patient
- patient Nicholas Aron Ferry
- Provider
- provider Dorene Swaniawski
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Humana
Record id
00710614-34f5-5b84-ec9c-5ce405704fdf