Claim total
$1,183.77
base $93.39 · payer covered $1,033.77
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1989-06-25
- Stop
- 1989-06-25
The parties
- Patient
- patient Krista Jenniffer Kautzer
- Provider
- provider Hassie Beer
- Payer
- payer Medicaid
Record id
0f6846d9-5866-3324-3aa2-24c8200606ff