Claim total
$1,142.00
base $93.83 · payer covered $913.59
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-03-06
- Stop
- 2017-03-06
The parties
- Patient
- patient Linh Sindy Heaney
- Provider
- provider Matt Shanahan
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Medicare
Record id
013d575b-4a77-458a-0a66-ebb31efb6efd