Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2016-11-20
- Stop
- 2016-11-20
The parties
- Patient
- patient Faustino Romeo Bauch
- Provider
- provider Janette Fisher
- Payer
- payer Medicaid
Record id
03e24eff-3793-eaeb-6b99-431604b887c9