Claim total
$775.00
base $93.83 · payer covered $775.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-02-24
- Stop
- 2024-02-24
The parties
- Patient
- patient Clarine Nana Kiehn
- Provider
- provider Cristina Schmitt
- Care site
- care site DUE NORTH WELLNESS CENTER PLLC
- Payer
- payer Medicaid
Record id
05754ab1-1584-1eea-c9e1-06340de77608