Claim total
$3,635.32
base $93.39 · payer covered $3,585.32
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Neoplasm of prostate126906006
- Start
- 1985-01-31
- Stop
- 1985-02-01
The parties
- Patient
- patient Bob Sergio O'Hara
- Provider
- provider Andria Spinka
- Payer
- payer Medicaid
Record id
261c034c-cc44-5f0f-e48d-6df0bc70ec81