Claim total
$976.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-03-22
- Stop
- 2023-03-23
The parties
- Patient
- patient Carolee Shenna Franecki
- Provider
- provider Brianne Erdman
- Care site
- care site DAKOTA MEDICAL CLINIC, PA
Record id
05da998f-3dd0-aeca-3031-2028a0ebe985