Claim total
$640.69
base $93.39 · payer covered $512.55
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2025-10-25
- Stop
- 2025-10-25
The parties
- Patient
- patient Jani Yolando Nitzsche
- Provider
- provider Liz Kozey
- Payer
- payer Medicare
Record id
04f07ca4-67b1-b65a-fd04-d583a644df77