Claim total
$12,559.96
base $93.39 · payer covered $10,047.96
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2014-03-10
- Stop
- 2014-03-10
The parties
- Patient
- patient Maria Dibbert
- Provider
- provider Cornelia Altenwerth
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Medicare
Record id
000287f5-a0d8-f77b-ae90-920664c39337