Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2022-11-10
- Stop
- 2022-11-11
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Adelia Dickens
- Care site
- care site WELLNESS CENTERS, PLLC
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-dd78-7dd390b429ab