Claim total
$776.69
base $93.39 · payer covered $670.08
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2010-06-27
- Stop
- 2010-06-27
The parties
- Patient
- patient Rex Jules Denesik
- Provider
- provider Walter Volkman
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
06303127-1d9c-5fa8-1d62-72433994a74d