Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Wheat412071004
- Start
- 2018-04-15
- Stop
- 2018-04-15
The parties
- Patient
- patient Alfonso Arnold Kautzer
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
0798f71c-1ec2-447d-d8a4-f96eeb342273