Claim total
$1,028.87
base $93.39 · payer covered $993.87
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2026-05-03
- Stop
- 2026-05-03
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Jarvis Braun
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Dual Eligible
Record id
03478e49-59cf-7140-cf03-a298f6ff94a5