Claim total
$567.97
base $93.39 · payer covered $417.97
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2014-04-08
- Stop
- 2014-04-08
The parties
- Patient
- patient Nicky Kristi Wiegand
- Provider
- provider Lady Frami
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
0358d022-e88b-b208-9601-bc007f090e1a