Claim total
$976.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2010-12-13
- Stop
- 2010-12-13
The parties
- Patient
- patient Erna Gayla Mayert
- Provider
- provider Mitzie Kuhic
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Humana
Record id
30cfe8d1-eb95-8f71-bf6e-aa49d0fe4de4