Claim total
$3,954.14
base $93.39 · payer covered $3,919.14
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2015-01-16
- Stop
- 2015-01-16
The parties
- Patient
- patient Nena Josephine Stehr
- Provider
- provider Dorethea Predovic
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
00eec58c-8547-4a29-0389-bd5405c56d29