Claim total
$4,159.79
base $93.39 · payer covered $4,124.79
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2014-09-26
- Stop
- 2014-09-26
The parties
- Patient
- patient Nena Josephine Stehr
- Provider
- provider Pa Kulas
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
00eec58c-8547-4a29-fc9b-4e8c70a3dff7