Claim total
$505.13
base $93.83 · payer covered $217.70
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1955-12-07
- Stop
- 1955-12-07
The parties
- Patient
- patient Louie Petrina Ziemann
- Provider
- provider Dorene Swaniawski
- Care site
- care site ALLIANCE WELLNESS CENTER LLC
- Payer
- payer Medicare
Record id
2db8ed08-2422-5c8b-7f21-63a133afee68