Claim total
$846.34
base $93.39 · payer covered $696.34
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1970-01-16
- Stop
- 1970-01-16
The parties
- Patient
- patient Ronnie Ina Gusikowski
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
003b30a0-7fd2-f42c-5b91-167e67838860