Claim total
$221.46
base $155.66 · payer covered $177.17
The visit
- Class
- Ambulatory
- Code
- 410410006
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2019-12-28
- Stop
- 2019-12-28
The parties
- Patient
- patient Jani Yolando Nitzsche
- Provider
- provider Sharla Ziemann
- Payer
- payer Medicare
Record id
04f07ca4-67b1-b65a-4203-ca3f71ec5b03