Claim total
$777.13
base $93.83 · payer covered $627.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-05-21
- Stop
- 2005-05-21
The parties
- Patient
- patient Sharie Nikia Hegmann
- Provider
- provider Mitzie Kuhic
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
00decd7e-554a-447f-a573-9a2cc091bf8e