Claim total
$840.41
base $93.83 · payer covered $840.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-08-17
- Stop
- 2025-08-17
The parties
- Patient
- patient Connie Buck Hane
- Provider
- provider Billie Abbott
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Dual Eligible
Record id
02070c62-d383-1025-4c32-076662030b40