Claim total
$640.69
base $93.39 · payer covered $590.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1983-01-12
- Stop
- 1983-01-12
The parties
- Patient
- patient Susanna Avis Emard
- Provider
- provider Janette Fisher
- Payer
- payer Medicaid
Record id
0443166c-c803-503e-28db-05aeb4cdf090