Claim total
$1,109.84
base $93.39 · payer covered $1,059.84
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2002-06-05
- Stop
- 2002-06-05
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Rosio Gleason
- Payer
- payer Medicaid
Record id
0324eea5-bb16-c29a-a16a-c2e9cf511a94