Claim total
$1,187.99
base $93.39 · payer covered $1,152.99
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2012-05-18
- Stop
- 2012-05-18
The parties
- Patient
- patient Abe Adolph Berge
- Provider
- provider Catalina Weimann
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Dual Eligible
Record id
035310e6-92e0-05c1-eb95-0b123523011c