Claim total
$1,186.30
base $93.83 · payer covered $763.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1992-11-02
- Stop
- 1992-11-02
The parties
- Patient
- patient Denny Rodrigo Cole
- Provider
- provider Kristofer Hettinger
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
01d0b380-425a-3ac7-b695-8dcf2c33239f