Claim total
$1,173.56
base $93.83 · payer covered $1,173.56
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-01-27
- Stop
- 2012-01-27
The parties
- Patient
- patient Wilson Teodoro Kihn
- Provider
- provider Mitzie Kuhic
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
04540647-5ff4-de4a-1762-b4dc70f3c92c