Claim total
$1,233.01
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1952-05-26
- Stop
- 1952-05-26
The parties
- Patient
- patient Denny Rodrigo Cole
- Provider
- provider Roxana Schuppe
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer No insurance
Record id
01d0b380-425a-3ac7-165c-c5d517a1def8