Claim total
$1,111.92
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2004-12-22
- Stop
- 2004-12-22
The parties
- Patient
- patient Elisha Sergio Champlin
- Provider
- provider Ines Kautzer
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
0ae894da-e84d-0c09-3157-a1dde8f97251