Claim total
$1,041.77
base $93.83 · payer covered $941.77
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-10-23
- Stop
- 2022-10-23
The parties
- Patient
- patient King Jerry Mueller
- Provider
- provider Danica Stracke
- Care site
- care site CROWN MEDICAL CENTER
- Payer
- payer Medicaid
Record id
337abc94-45df-d035-10bc-fe9c59468468