Claim total
$846.78
base $93.83 · payer covered $696.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1949-10-10
- Stop
- 1949-10-10
The parties
- Patient
- patient Linh Sindy Heaney
- Provider
- provider Matt Shanahan
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Medicaid
Record id
013d575b-4a77-458a-d594-1a68b6c7c6cc