Claim total
$157.11
base $93.83 · payer covered $157.11
The visit
- Class
- Wellness
- Code
- 308646001
- Reason
- diagnosis concept Chronic congestive heart failure88805009
- Start
- 2026-06-26
- Stop
- 2026-06-26
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Billie Abbott
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Dual Eligible
Record id
05c57aa9-c3e8-2f04-2f4b-9dd938162db7