Claim total
$229.39
base $93.39 · payer covered $179.39
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2017-10-08
- Stop
- 2017-10-08
The parties
- Patient
- patient Margo Green
- Provider
- provider Altagracia Rippin
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
029fe5e1-f60c-f237-7878-fd00b864996b