Claim total
$982.78
base $93.83 · payer covered $982.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-03-08
- Stop
- 2016-03-08
The parties
- Patient
- patient Cleo Timothy Kemmer
- Provider
- provider Danica Stracke
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Medicaid
Record id
04d0e486-8d5f-7bad-699c-cd3024e327b1