Claim total
$1,105.92
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-02-26
- Stop
- 2018-02-26
The parties
- Patient
- patient Otha Jewel Ankunding
- Provider
- provider Adelia Dickens
- Care site
- care site WELLNESS CENTERS, PLLC
Record id
01bd7d75-9405-280a-318a-6224ef9d4222