Claim total
$213.73
base $93.39 · payer covered $178.73
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2024-12-05
- Stop
- 2024-12-05
The parties
- Patient
- patient Ferdinand Kasey Ernser
- Provider
- provider Heriberto Smitham
- Payer
- payer Dual Eligible
Record id
062e401f-723c-d87d-80cc-e8b005d1bc0b