Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1975-09-22
- Stop
- 1975-09-22
The parties
- Patient
- patient Carolee Lorette Nienow
- Provider
- provider Mitzie Kuhic
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer No insurance
Record id
162c02fb-cffd-80fd-fbea-20aa6ec1b89e