Claim total
$963.46
base $93.39 · payer covered $913.46
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2025-05-11
- Stop
- 2025-05-11
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Jonas Pouros
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
03478e49-59cf-7140-8090-1e97265daddd