Claim total
$846.78
base $93.83 · payer covered $696.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-09-07
- Stop
- 1999-09-07
The parties
- Patient
- patient Annamarie Mollie Hoppe
- Provider
- provider Mitzie Kuhic
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
0555f11c-c453-57eb-1abc-aa85a52581fd