Claim total
$916.15
base $93.83 · payer covered $916.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-02-11
- Stop
- 2022-02-11
The parties
- Patient
- patient Jeremy Kyle Walsh
- Provider
- provider Adriene Wisozk
- Care site
- care site TWIN CITIES MEDICAL CLINIC PC
- Payer
- payer Medicaid
Record id
0c7bdee8-0edc-bfd2-ccd6-cc4f9e20f374