Claim total
$2,623.46
base $155.66 · payer covered $2,098.77
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- —
- Start
- 2015-06-29
- Stop
- 2015-06-29
The parties
- Patient
- patient Lesia Catalina Ledner
- Provider
- provider Celesta Shields
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Medicare
Record id
058279b6-7701-4823-f2c0-7b943e592175