Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2021-07-18
- Stop
- 2021-07-18
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-bd10-9a8fd8664c57