Claim total
$711.72
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-07-19
- Stop
- 2024-07-19
The parties
- Provider
- provider Danica Stracke
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Cigna Health
Record id
02e77898-0a14-d00d-32e9-c3f82f7df6ff