Claim total
$219.95
base $93.39 · payer covered $184.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- —
- Start
- 2024-01-09
- Stop
- 2024-01-09
The parties
- Patient
- patient Benito Delao
- Provider
- provider Jonas Pouros
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Dual Eligible
Record id
30bb6e62-6649-f6c6-ce6a-d796bd866ff4