Claim total
$767.69
base $93.83 · payer covered $767.69
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-05-01
- Stop
- 1996-05-01
The parties
- Patient
- patient Christel Torp
- Provider
- provider Brianne Erdman
- Care site
- care site DAKOTA MEDICAL CLINIC, PA
Record id
00edd987-99b7-13d9-e61d-e06ba35fc746