Claim total
$767.69
base $93.83 · payer covered $614.14
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-10-13
- Stop
- 2018-10-13
The parties
- Provider
- provider Roxana Schuppe
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
018a1080-c6e3-9b93-9d05-c23c2f05e9d9