Claim total
$821.53
base $93.83 · payer covered $657.20
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-11-16
- Stop
- 2024-11-16
The parties
- Provider
- provider Dorene Swaniawski
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
018a1080-c6e3-9b93-2e50-0c994a9122dc