Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-03-14
- Stop
- 2018-03-14
The parties
- Patient
- patient Chana Jung Kuhlman
- Provider
- provider Matt Shanahan
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Aetna
Record id
0b9ae72a-4873-5d31-e785-1551dcfd27a1