Claim total
$1,326.12
base $93.83 · payer covered $1,176.12
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-04-23
- Stop
- 1983-04-23
The parties
- Patient
- patient Crista Kristin Stehr
- Provider
- provider Adriene Wisozk
- Care site
- care site TWIN CITIES MEDICAL CLINIC PC
- Payer
- payer Medicaid
Record id
1ebf266f-db79-48d9-6d75-7b65c5aa392d