Claim total
$566.96
base $155.66 · payer covered $531.96
The visit
- Class
- Ambulatory
- Code
- 439740005
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2025-03-31
- Stop
- 2025-03-31
The parties
- Patient
- patient Rocio Margarita Alcaraz
- Provider
- provider Claud Braun
- Payer
- payer Dual Eligible
Record id
0274bb53-c777-eb96-b9fe-eebc6863cd1a