Claim total
$757.81
base $93.39 · payer covered $722.81
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2012-10-05
- Stop
- 2012-10-05
The parties
- Patient
- patient Nena Josephine Stehr
- Provider
- provider María Soledad Archuleta
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
00eec58c-8547-4a29-cf9e-81b46d823e91