Claim total
$1,311.92
base $93.83 · payer covered $1,049.52
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-01-10
- Stop
- 2005-01-10
The parties
- Patient
- patient Denny Rodrigo Cole
- Provider
- provider Dorene Swaniawski
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
01d0b380-425a-3ac7-894c-b1a3e2f953d0