Claim total
$893.63
base $93.39 · payer covered $843.63
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2026-08-18
- Stop
- 2026-08-18
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Trinity Mraz
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-9336-d700007429e6