Claim total
$3,098.04
base $155.66 · payer covered $3,063.04
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- —
- Start
- 2015-09-29
- Stop
- 2015-09-29
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-d19f-6997b6f1526e