Claim total
$219.95
base $93.39 · payer covered $175.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- —
- Start
- 2017-03-06
- Stop
- 2017-03-06
The parties
- Patient
- patient Sheldon Milan Koch
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Anthem
Record id
28fc4489-6f3e-4157-d683-78f74c64b072