Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Partial thickness burn403191005
- Start
- 2026-01-01
- Stop
- 2026-01-01
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-a332-6dfd8153e0a4