Claim total
$1,169.55
base $93.83 · payer covered $935.62
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-02-21
- Stop
- 2011-02-21
The parties
- Patient
- patient Denny Rodrigo Cole
- Provider
- provider Dorene Swaniawski
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
01d0b380-425a-3ac7-5a1f-e90b083c9c9a