Claim total
$694.97
base $93.83 · payer covered $555.96
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2006-01-23
- Stop
- 2006-01-23
The parties
- Patient
- patient Denny Rodrigo Cole
- Provider
- provider Jose Pollich
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
01d0b380-425a-3ac7-b707-0b0afc3191be