Claim total
$1,519.03
base $93.39 · payer covered $1,369.03
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2000-05-22
- Stop
- 2000-05-22
The parties
- Patient
- patient Tosha Lorie Welch
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
2c9d7a25-c461-e460-5609-5678d6246ffd