Claim total
$219.95
base $93.39 · payer covered $169.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- —
- Start
- 2014-11-26
- Stop
- 2014-11-26
The parties
- Patient
- patient Tuan Jarred Volkman
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
148a1791-9b8b-0048-5d63-459923686e6c