Claim total
$704.41
base $93.83 · payer covered $704.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-01-27
- Stop
- 2018-01-27
The parties
- Provider
- provider Billie Abbott
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicaid
Record id
04424811-b26b-3a54-e7b6-6a6ac879b2fb