Claim total
$985.80
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1994-12-12
- Stop
- 1994-12-12
The parties
- Patient
- patient Roscoe Garrett Towne
- Provider
- provider Matt Shanahan
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer No insurance
Record id
19f34a84-17cb-b239-86b7-6dfd193bc15c