Claim total
$1,217.86
base $93.83 · payer covered $1,067.86
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1997-05-31
- Stop
- 1997-05-31
The parties
- Patient
- patient Tuan Jarred Volkman
- Provider
- provider Katherin Wintheiser
- Care site
- care site WELLNESS WAY BLOOMINGTON LLC
- Payer
- payer Medicaid
Record id
148a1791-9b8b-0048-d869-e0eb4f478b18