Claim total
$694.53
base $93.39 · payer covered $644.53
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2024-11-06
- Stop
- 2024-11-06
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Criselda Bartell
- Payer
- payer Medicaid
Record id
0324eea5-bb16-c29a-f8f6-941dc6b33f23