Claim total
$1,384.64
base $93.83 · payer covered $922.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1986-09-29
- Stop
- 1986-09-29
The parties
- Patient
- patient Denny Rodrigo Cole
- Provider
- provider Kristofer Hettinger
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
01d0b380-425a-3ac7-bb2d-86b96e0cb29c