Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2021-08-31
- Stop
- 2021-08-31
The parties
- Patient
- patient Janie Ranae Botsford
- Provider
- provider Matt Shanahan
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer No insurance
Record id
041efb3a-8e81-3ea8-063c-e525fd2b24dd