Claim total
$126.63
base $93.39 · payer covered $76.63
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2024-04-30
- Stop
- 2024-04-30
The parties
- Patient
- patient Jacqui Bess Baumbach
- Provider
- provider Carmine Carter
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
019cda32-2557-7f65-fd6e-6d6fef4c5171