Claim total
$894.25
base $93.83 · payer covered $715.38
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-02-09
- Stop
- 2009-02-09
The parties
- Patient
- patient Denny Rodrigo Cole
- Provider
- provider Roxana Schuppe
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
01d0b380-425a-3ac7-6ae6-b15973f92bd7