Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2020-02-11
- Stop
- 2020-02-11
The parties
- Patient
- patient Cristobal Dana Wolf
- Provider
- provider Georgetta Kohler
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
016cc0d6-9a88-e8dc-0bfe-054a363ff329