Claim total
$1,638.95
base $93.83 · payer covered $1,638.95
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-09-04
- Stop
- 2021-09-04
The parties
- Patient
- patient Kevin Lorriane Watsica
- Provider
- provider Billie Abbott
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicaid
Record id
13023c5f-e380-bae7-d3fa-25dcfa4e1b78