Claim total
$112.68
base $93.39 · payer covered $90.14
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2011-10-22
- Stop
- 2011-10-22
The parties
- Patient
- patient Jani Yolando Nitzsche
- Provider
- provider Heriberto Smitham
- Payer
- payer Medicare
Record id
04f07ca4-67b1-b65a-4080-f3e59b150cc4