Claim total
$1,527.01
base $93.83 · payer covered $1,427.01
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-07-02
- Stop
- 2017-07-02
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-d383-1025-6b08-082bc3c09e41