Claim total
$1,143.89
base $93.39 · payer covered $1,093.89
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2017-09-17
- Stop
- 2017-09-17
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Kasi Schamberger
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
03478e49-59cf-7140-14c7-09426e4cd09a