Claim total
$466.94
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-03-24
- Stop
- 2018-03-24
The parties
- Patient
- patient Malvina Jodie Funk
- Provider
- provider Matt Shanahan
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Humana
Record id
3566cc77-5678-10db-ea14-b4af96338bbc