Claim total
$1,327.29
base $93.39 · payer covered $1,277.29
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2021-12-20
- Stop
- 2021-12-20
The parties
- Patient
- patient Alyssa Star Feil
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Medicaid
Record id
02cca109-7737-4ad8-7f38-a80c74f750b4