Claim total
$694.53
base $93.39 · payer covered $659.53
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2020-11-25
- Stop
- 2020-11-25
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Hazel Effertz
- Payer
- payer Dual Eligible
Record id
0324eea5-bb16-c29a-722f-e17a987b1b19