Claim total
$1,230.45
base $93.83 · payer covered $1,080.45
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1981-03-27
- Stop
- 1981-03-27
The parties
- Patient
- patient Warren Kenny Blanda
- Provider
- provider Miles Kuphal
- Care site
- care site WELLNESS CENTERS, PLLC
- Payer
- payer Medicaid
Record id
27d90396-195c-bf7b-ef04-463f87a018fc