Claim total
$777.13
base $93.83 · payer covered $777.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-10-08
- Stop
- 2016-10-08
The parties
- Provider
- provider Shaun Hills
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer Dual Eligible
Record id
021142be-3a32-af72-8341-bf7d8879d6fe