Claim total
$777.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2016-04-26
- Stop
- 2016-04-26
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-ade3-93b836dfbeda