Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2007-01-27
- Stop
- 2007-01-27
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Noe Hills
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
01bbe7d1-151b-3eec-8e15-bd8a52f756be