Claim total
$1,497.50
base $93.39 · payer covered $1,447.50
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Anemia271737000
- Start
- 2009-05-12
- Stop
- 2009-05-12
The parties
- Patient
- patient Louella Roberts
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
05092f50-4c35-2d72-1a0c-1a9385e5950f