Claim total
$1,218.97
base $93.83 · payer covered $1,218.97
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-01-20
- Stop
- 2018-01-20
The parties
- Patient
- patient Clarine Nana Kiehn
- Provider
- provider Clair White
- Care site
- care site DUE NORTH WELLNESS CENTER PLLC
- Payer
- payer Medicaid
Record id
05754ab1-1584-1eea-1cb7-ccd3234f7d5e