Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2000-06-28
- Stop
- 2000-06-28
The parties
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-544e-1e80f1870982