Claim total
$840.41
base $93.83 · payer covered $740.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-12-15
- Stop
- 2008-12-15
The parties
- Patient
- patient Jarod Clyde Sipes
- Provider
- provider Mitzie Kuhic
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
32122cd6-5f93-fb84-7054-f5420d8a8598