Claim total
$1,048.46
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2021-03-02
- Stop
- 2021-03-02
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-f0f3-5a430e33481d