Claim total
$1,318.06
base $93.83 · payer covered $1,218.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-05-25
- Stop
- 2014-05-25
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-e8ae-1a91fe0c725f