Claim total
$483.65
base $93.39 · payer covered $433.65
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2016-11-05
- Stop
- 2016-11-05
The parties
- Patient
- patient Gerardo Marvin Johns
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
01513b97-46a6-1303-3c08-270d4c394671