Claim total
$505.13
base $93.83 · payer covered $217.70
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1987-10-17
- Stop
- 1987-10-17
The parties
- Provider
- provider Roxana Schuppe
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
018a1080-c6e3-9b93-6c0a-eabfc77b2ce1