Claim total
$966.97
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-10-19
- Stop
- 2015-10-19
The parties
- Patient
- patient Roscoe Garrett Towne
- Provider
- provider Danica Stracke
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Cigna Health
Record id
19f34a84-17cb-b239-0e1d-09968d021eab