Claim total
$1,112.41
base $93.83 · payer covered $1,012.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-04-13
- Stop
- 2013-04-13
The parties
- Provider
- provider Mitzie Kuhic
- Care site
- care site WEST METRO WELLNESS PC
- Payer
- payer Medicaid
Record id
34ca1156-190d-d8c9-131a-4abaad585328