Claim total
$640.69
base $93.39 · payer covered $490.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1977-03-05
- Stop
- 1977-03-05
The parties
- Patient
- patient Irving Steve Legros
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
02796652-7893-0df9-3c50-a154c467c684