Claim total
$1,037.32
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-08-22
- Stop
- 2023-08-22
The parties
- Provider
- provider Jose Pollich
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Humana
Record id
032df52f-9699-4603-d90b-73ba3283c6a3