Claim total
$917.37
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1970-06-29
- Stop
- 1970-06-29
The parties
- Patient
- patient Denny Rodrigo Cole
- Provider
- provider Kristofer Hettinger
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer No insurance
Record id
01d0b380-425a-3ac7-2f18-db3e9b3e8074