Claim total
$775.00
base $93.83 · payer covered $775.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-08-21
- Stop
- 2021-08-21
The parties
- Patient
- patient Maricela Gaye Labadie
- Provider
- provider Billie Abbott
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicaid
Record id
204f0e38-5f88-c3c2-c683-48d7225fe10f