Claim total
$1,590.29
base $93.83 · payer covered $1,590.29
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-02-12
- Stop
- 2022-02-12
The parties
- Patient
- patient Clarine Nana Kiehn
- Provider
- provider Julieann Christiansen
- Care site
- care site DUE NORTH WELLNESS CENTER PLLC
- Payer
- payer Medicaid
Record id
05754ab1-1584-1eea-79e1-f2b8bd7ad300