Claim total
$1,523.89
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1957-06-04
- Stop
- 1957-06-04
The parties
- Patient
- patient Homer Heller
- Provider
- provider Danica Stracke
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer No insurance
Record id
0705a4ea-b416-ffcc-1633-35efa4917605