Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1968-07-05
- Stop
- 1968-07-05
The parties
- Patient
- patient Donnette Abbott
- Provider
- provider Dorene Swaniawski
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer No insurance
Record id
2e9b1698-0505-99a0-884b-46ba8425a5b0