Claim total
$703.97
base $93.39 · payer covered $653.97
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2020-11-16
- Stop
- 2020-11-16
The parties
- Patient
- patient Nana Earlean Kuphal
- Provider
- provider Marcus Douglas
- Payer
- payer Medicaid
Record id
01077a3b-80bd-4b83-473a-ef490ef8ddde