Claim total
$211.25
base $93.39 · payer covered $161.25
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2011-08-14
- Stop
- 2011-08-14
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Altagracia Rippin
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
03478e49-59cf-7140-4054-a6403d301a18