Claim total
$1,436.80
base $93.39 · payer covered $1,386.80
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2025-01-12
- Stop
- 2025-01-12
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Tiffany Smitham
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
03478e49-59cf-7140-f078-b759586c71d1