Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-04-01
- Stop
- 2024-04-01
The parties
- Patient
- patient Otha Jewel Ankunding
- Provider
- provider Adelia Dickens
- Care site
- care site WELLNESS CENTERS, PLLC
Record id
01bd7d75-9405-280a-f40b-e6e965bedcfe