Claim total
$219.95
base $93.39 · payer covered $169.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- —
- Start
- 2001-10-13
- Stop
- 2001-10-13
The parties
- Provider
- provider Pasquale Grimes
- Payer
- payer Medicaid
Record id
193e4bb3-7266-1ac6-55cf-02579941fdd6