Claim total
$704.41
base $93.83 · payer covered $377.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-07-28
- Stop
- 2020-07-28
The parties
- Patient
- patient Eulah Avril Aufderhar
- Provider
- provider Danica Stracke
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Medicare
Record id
02aef5a1-9ba3-229b-9b89-2ee0225647f6