Claim total
$1,266.37
base $93.83 · payer covered $1,266.37
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-04-15
- Stop
- 2016-04-15
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Billie Abbott
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Dual Eligible
Record id
05c57aa9-c3e8-2f04-33a1-dcf14e7eaba5