Claim total
$9,994.84
base $93.39 · payer covered $9,959.84
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Neoplasm of prostate126906006
- Start
- 2013-12-20
- Stop
- 2013-12-21
The parties
- Patient
- patient Otis Jed Price
- Provider
- provider Andria Spinka
- Payer
- payer Dual Eligible
Record id
1d8b9eda-b86e-378b-b329-81fa51ff807c