Claim total
$1,099.46
base $93.39 · payer covered $1,064.46
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2012-05-11
- Stop
- 2012-05-11
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-8547-4a29-632b-2cb02cf8f146