Claim total
$263.00
base $155.66 · payer covered $213.00
The visit
- Class
- Ambulatory
- Code
- 410410006
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2019-07-31
- Stop
- 2019-07-31
The parties
- Patient
- patient Rocio Margarita Alcaraz
- Provider
- provider Claud Braun
- Payer
- payer Medicaid
Record id
0274bb53-c777-eb96-08f5-cc831353b6a1