Claim total
$1,457.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-06-27
- Stop
- 2008-06-27
The parties
- Provider
- provider Matt Shanahan
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Anthem
Record id
02e77898-0a14-d00d-aa59-20694334f5b7