Claim total
$728.92
base $93.39 · payer covered $678.92
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2020-04-05
- Stop
- 2020-04-05
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Jo Stiedemann
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-51b3-93895f98bcf4