Claim total
$187.11
base $93.39 · payer covered $137.11
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2006-09-09
- Stop
- 2006-09-09
The parties
- Patient
- patient Gerardo Marvin Johns
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
01513b97-46a6-1303-7b0d-af768c4c2ee5