Claim total
$710.34
base $93.39 · payer covered $660.34
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2024-04-13
- Stop
- 2024-04-13
The parties
- Patient
- patient Dorotea Yolanda Palomo
- Provider
- provider Dale Mertz
- Payer
- payer Medicaid
Record id
04ad2732-b952-4fbb-0da4-8e24e7a0cd7d