Claim total
$4,486.25
base $93.83 · payer covered $4,486.25
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-07-22
- Stop
- 2017-07-22
The parties
- Patient
- patient Sharie Nikia Hegmann
- Provider
- provider Mitzie Kuhic
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Dual Eligible
Record id
00decd7e-554a-447f-2a4a-db804fae4471