Claim total
$3,034.76
base $155.66 · payer covered $2,999.76
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- diagnosis concept Diabetes mellitus type 244054006
- Start
- 2023-11-19
- Stop
- 2023-11-19
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Kasi Schamberger
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Dual Eligible
Record id
03478e49-59cf-7140-6338-ba47c5e28c5b