Claim total
$772.84
base $93.83 · payer covered $618.26
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-10-30
- Stop
- 2008-10-30
The parties
- Patient
- patient Logan Stuart Hettinger
- Provider
- provider Tennille Baumbach
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer Medicare
Record id
2f6f1d59-7737-7d41-8e35-2f9d7c0a49ae