Claim total
$779.71
base $93.39 · payer covered $629.71
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2022-10-03
- Stop
- 2022-10-03
The parties
- Patient
- patient Columbus Kerluke
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Medicaid
Record id
38f2e58f-5d08-f8a7-1b53-11a03ff13580