Claim total
$934.62
base $93.83 · payer covered $747.68
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-01-29
- Stop
- 2007-01-29
The parties
- Patient
- patient Denny Rodrigo Cole
- Provider
- provider Roxana Schuppe
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
01d0b380-425a-3ac7-ca36-344896f05138