Claim total
$631.25
base $93.39 · payer covered $504.99
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2004-05-05
- Stop
- 2004-05-05
The parties
- Patient
- patient Donny Wilfred Ruecker
- Provider
- provider Rosio Gleason
- Payer
- payer Medicare
Record id
0054427e-44d7-94b2-4b35-a27aa655e741