Claim total
$780.15
base $93.83 · payer covered $730.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-12-18
- Stop
- 2002-12-18
The parties
- Patient
- patient Chana Jung Kuhlman
- Provider
- provider Danica Stracke
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Medicaid
Record id
0b9ae72a-4873-5d31-b5b0-e75fa456c9c4