Claim total
$1,527.01
base $93.83 · payer covered $1,038.99
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-04-02
- Stop
- 2025-04-02
The parties
- Patient
- patient Man Quinton Hintz
- Provider
- provider Brianne Erdman
- Care site
- care site DAKOTA MEDICAL CLINIC, PA
- Payer
- payer Medicare
Record id
19aaec98-0e39-87a2-33f0-c0019647769b