Claim total
$501.32
base $93.39 · payer covered $451.32
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2019-12-08
- Stop
- 2019-12-08
The parties
- Patient
- patient Faustino Romeo Bauch
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
03e24eff-3793-eaeb-cdea-e51312dd180c