Claim total
$171.17
base $93.39 · payer covered $136.93
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2024-10-05
- Stop
- 2024-10-05
The parties
- Patient
- patient Porfirio West
- Provider
- provider Dorethea Predovic
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicare
Record id
05880a71-6004-727f-1494-286ae65257d5