Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Fish735971005
- Start
- 2008-07-22
- Stop
- 2008-07-22
The parties
- Patient
- patient Jerome Gaylord Lueilwitz
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1326c004-812d-82f3-a5d3-72af8b68046c