Claim total
$1,178.79
base $93.83 · payer covered $825.17
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-04-07
- Stop
- 2021-04-07
The parties
- Patient
- patient Christel Torp
- Provider
- provider Brianne Erdman
- Care site
- care site DAKOTA MEDICAL CLINIC, PA
Record id
00edd987-99b7-13d9-277f-3c2648be43e9