Claim total
$1,527.01
base $93.83 · payer covered $1,527.01
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-04-23
- Stop
- 2024-04-23
The parties
- Patient
- patient Cleo Timothy Kemmer
- Provider
- provider Danica Stracke
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Medicaid
Record id
04d0e486-8d5f-7bad-6447-f709bf8a07d5