Claim total
$157.11
base $93.83 · payer covered $107.11
The visit
- Class
- Wellness
- Code
- 308646001
- Reason
- diagnosis concept Bullet wound262574004
- Start
- 1977-03-11
- Stop
- 1977-03-11
The parties
- Patient
- patient Ronnie Ina Gusikowski
- Provider
- provider Lowell Blick
- Payer
- payer Medicaid
Record id
003b30a0-7fd2-f42c-b662-86f7f6b53581