Claim total
$219.95
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- —
- Start
- 2005-01-22
- Stop
- 2005-01-22
The parties
- Patient
- patient Elisha Sergio Champlin
- Provider
- provider Octavio Dibbert
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
0ae894da-e84d-0c09-8c84-1557066f84b4