Claim total
$1,590.29
base $93.83 · payer covered $1,440.29
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-07-29
- Stop
- 1991-07-29
The parties
- Patient
- patient Darron Luigi Kuhlman
- Provider
- provider Shaun Hills
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer Medicaid
Record id
2ca6daed-ad8b-5612-4db3-566172ff28aa