Claim total
$1,267.01
base $93.83 · payer covered $1,013.59
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-11-22
- Stop
- 2025-11-22
The parties
- Provider
- provider Dorene Swaniawski
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
018a1080-c6e3-9b93-8a40-848e4ce769d2