Claim total
$641.13
base $93.83 · payer covered $641.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-01-03
- Stop
- 2015-01-03
The parties
- Patient
- patient Clarine Nana Kiehn
- Provider
- provider Cristina Schmitt
- Care site
- care site DUE NORTH WELLNESS CENTER PLLC
- Payer
- payer Medicaid
Record id
05754ab1-1584-1eea-4cda-b0ad2bc9f305