Claim total
$1,185.08
base $93.83 · payer covered $1,185.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-02-14
- Stop
- 2014-02-14
The parties
- Patient
- patient Craig Olin Cassin
- Provider
- provider Dan Leuschke
- Care site
- care site WELLNESS CENTERS, PLLC
- Payer
- payer Medicaid
Record id
255f4784-1651-1fb2-5d11-24920c3c327b