Claim total
$609.06
base $127.17 · payer covered $303.97
The visit
- Class
- Emergency
- Code
- 50849002
- Reason
- —
- Start
- 1985-08-26
- Stop
- 1985-08-26
The parties
- Patient
- patient Gale Stokes
- Provider
- provider Ismael Botsford
- Care site
- care site WSCHS, INC - AGAPE CLINIC
- Payer
- payer Medicare
Record id
01a64b50-bd68-5ef7-4dfd-586a824aa0a1