Claim total
$192.15
base $93.39 · payer covered $153.72
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Suicidal poisoning86849004
- Start
- 1981-05-30
- Stop
- 1981-05-30
The parties
- Patient
- patient Pete Roberto Streich
- Provider
- provider Avery Mayer
- Payer
- payer Medicare
Record id
29a638b7-ee8f-0f2e-4734-30e699ad5aaf