Claim total
$1,294.65
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-09-23
- Stop
- 2023-09-23
The parties
- Patient
- patient Reatha Victor O'Conner
- Provider
- provider Matt Shanahan
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Aetna
Record id
0521a0be-ba7b-b4e6-c917-68fcfb2c14c7