Claim total
$1,035.69
base $93.39 · payer covered $985.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2024-04-10
- Stop
- 2024-04-10
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Hazel Effertz
- Payer
- payer Medicaid
Record id
0324eea5-bb16-c29a-e03e-e549781fab23