Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2001-06-01
- Stop
- 2001-06-01
The parties
- Provider
- provider Matt Shanahan
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer No insurance
Record id
02e77898-0a14-d00d-088d-2bb27976b7bc