Claim total
$1,160.67
base $93.39 · payer covered $1,110.67
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2015-07-22
- Stop
- 2015-07-22
The parties
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-bdeb-408c78d51d82