Claim total
$1,099.90
base $93.83 · payer covered $769.95
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-03-21
- Stop
- 2018-03-21
The parties
- Patient
- patient Christel Torp
- Provider
- provider Brianne Erdman
- Care site
- care site DAKOTA MEDICAL CLINIC, PA
Record id
00edd987-99b7-13d9-8fef-b595e58bb773