Claim total
$910.06
base $93.83 · payer covered $810.06
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2021-11-18
- Stop
- 2021-11-18
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-e473-f1cd314becf7