Claim total
$910.06
base $93.83 · payer covered $910.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-02-23
- Stop
- 2007-02-23
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Billie Abbott
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicaid
Record id
05c57aa9-c3e8-2f04-a6b3-362f03a175de