Claim total
$93.44
base $93.39 · payer covered $43.44
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2025-05-25
- Stop
- 2025-05-25
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Wes Jast
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
03478e49-59cf-7140-7ca0-9f85f59e3c0f