Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2003-11-26
- Stop
- 2003-11-26
The parties
- Patient
- patient Donny Wilfred Ruecker
- Provider
- provider Ramiro Boehm
- Payer
- payer Medicare
Record id
0054427e-44d7-94b2-37a3-5425255c75dd