Claim total
$2,623.46
base $155.66 · payer covered $2,573.46
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- —
- Start
- 2025-10-09
- Stop
- 2025-10-09
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Garret Mohr
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
03478e49-59cf-7140-fc36-7cdc187a817c