Claim total
$2,623.46
base $155.66 · payer covered $2,573.46
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- —
- Start
- 1990-02-12
- Stop
- 1990-02-12
The parties
- Patient
- patient Nena Josephine Stehr
- Provider
- provider Chasidy Harris
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
00eec58c-8547-4a29-1db2-43ac74ed2564