Claim total
$767.69
base $93.83 · payer covered $767.69
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-02-24
- Stop
- 2017-02-24
The parties
- Patient
- patient Wilson Teodoro Kihn
- Provider
- provider Mitzie Kuhic
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
04540647-5ff4-de4a-b2d6-d6a74ce77b9c