Claim total
$972.12
base $93.83 · payer covered $922.12
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-03-11
- Stop
- 2004-03-11
The parties
- Patient
- patient Blanch Karine Kihn
- Provider
- provider Shaun Hills
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer Medicaid
Record id
2dd2c016-f9b3-9980-c55a-d7a2b9196f7c