Claim total
$767.69
base $93.83 · payer covered $505.58
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-07-24
- Stop
- 2007-07-24
The parties
- Patient
- patient Homer Heller
- Provider
- provider Danica Stracke
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Medicare
Record id
0705a4ea-b416-ffcc-75d2-402d93ba7a9f