Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-05-02
- Stop
- 2017-05-02
The parties
- Patient
- patient Cyndi Tromp
- Provider
- provider Matt Shanahan
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Humana
Record id
01936333-6290-e7a2-570c-1144c51a7fcd