Claim total
$846.34
base $93.39 · payer covered $796.34
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1993-02-10
- Stop
- 1993-02-10
The parties
- Patient
- patient Nichol Clara Predovic
- Provider
- provider Simon Bode
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
0130f9d2-4df9-4b02-7a67-9852a0883991