Claim total
$641.13
base $93.83 · payer covered $591.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-01-15
- Stop
- 1998-01-15
The parties
- Patient
- patient Travis Reichert
- Provider
- provider Billie Abbott
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicaid
Record id
0c81d398-2cb2-843e-4a62-2d93d6c3f80f