Claim total
$843.43
base $93.83 · payer covered $693.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1963-09-30
- Stop
- 1963-09-30
The parties
- Patient
- patient Darron Luigi Kuhlman
- Provider
- provider Tennille Baumbach
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer Medicaid
Record id
2ca6daed-ad8b-5612-b497-c90e729b6db5