Claim total
$1,402.71
base $93.83 · payer covered $1,402.71
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2025-11-27
- Stop
- 2025-11-28
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Adelia Dickens
- Care site
- care site WELLNESS CENTERS, PLLC
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-8b04-f36985f89773