Claim total
$571.04
base $93.39 · payer covered $521.04
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2018-07-04
- Stop
- 2018-07-04
The parties
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-3f69-f23214f284f9