Claim total
$75.00
base $75.00 · payer covered $25.00
The visit
- Class
- Virtual
- Code
- 185347001
- Reason
- diagnosis concept Osteoarthritis of hip239872002
- Start
- 2022-10-03
- Stop
- 2022-10-03
The parties
- Patient
- patient Herb Shelton Dooley
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
1a07e468-6352-fe11-f60e-aefb972bd45c