Claim total
$1,391.81
base $93.83 · payer covered $1,391.81
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-07-12
- Stop
- 2026-07-12
The parties
- Patient
- patient Terrance Raymon Kuhic
- Provider
- provider Venita Fahey
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer Medicaid
Record id
03e733d5-721a-3740-d988-6a05baeff69b