Claim total
$1,110.40
base $93.83 · payer covered $1,010.40
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2006-04-30
- Stop
- 2006-04-30
The parties
- Patient
- patient Connie Buck Hane
- Provider
- provider Billie Abbott
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicaid
Record id
02070c62-d383-1025-52b5-0180a011073f