Claim total
$641.13
base $93.83 · payer covered $641.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2010-05-16
- Stop
- 2010-05-16
The parties
- Patient
- patient Terrance Raymon Kuhic
- Provider
- provider Shaun Hills
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer Medicaid
Record id
03e733d5-721a-3740-3c44-a603a3422094