Claim total
$118.28
base $93.39 · payer covered $83.28
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2023-10-29
- Stop
- 2023-10-29
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Ines Kautzer
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Dual Eligible
Record id
03478e49-59cf-7140-6684-639e233a0bd4