Claim total
$3,120.23
base $155.66 · payer covered $3,070.23
The visit
- Class
- Ambulatory
- Code
- 169762003
- Reason
- —
- Start
- 2025-02-10
- Stop
- 2025-02-10
The parties
- Patient
- patient Alyssa Star Feil
- Provider
- provider Julee Jones
- Payer
- payer Medicaid
Record id
02cca109-7737-4ad8-8975-4b4ab0007871