Claim total
$157.11
base $93.83 · payer covered $157.11
The visit
- Class
- Wellness
- Code
- 308646001
- Reason
- diagnosis concept Small cell carcinoma of lung254632001
- Start
- 2023-04-25
- Stop
- 2023-04-25
The parties
- Patient
- patient Eulah Avril Aufderhar
- Provider
- provider Matt Shanahan
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Medicaid
Record id
02aef5a1-9ba3-229b-a38a-3f0a1f9d0e4d