Claim total
$979.43
base $93.83 · payer covered $597.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1981-09-04
- Stop
- 1981-09-04
The parties
- Patient
- patient Donnette Abbott
- Provider
- provider Roxana Schuppe
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
2e9b1698-0505-99a0-fb14-b66e853794fc