Claim total
$10,135.77
base $93.83 · payer covered $10,135.77
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-07-16
- Stop
- 2016-07-16
The parties
- Patient
- patient Sharie Nikia Hegmann
- Provider
- provider Mitzie Kuhic
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
00decd7e-554a-447f-9e17-0af507007101