Claim total
$641.13
base $93.83 · payer covered $541.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-05-20
- Stop
- 2026-05-20
The parties
- Patient
- patient Dong Borer
- Provider
- provider Danica Stracke
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Medicaid
Record id
06fe0fa1-aba9-b4f6-4d23-299a92b356f6