Claim total
$690.19
base $93.83 · payer covered $690.19
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-05-11
- Stop
- 2017-05-11
The parties
- Patient
- patient Terese Darla Williamson
- Provider
- provider Mitzie Kuhic
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
0098424c-ec2c-0924-aa44-7fbfba606ee8