Claim total
$901.56
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-01-13
- Stop
- 2001-01-13
The parties
- Patient
- patient Synthia Grady
- Provider
- provider Kristofer Hettinger
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer No insurance
Record id
33ff0b1a-8ac4-7085-020e-d32165da1c13