Claim total
$219.95
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- —
- Start
- 1984-12-30
- Stop
- 1984-12-30
The parties
- Patient
- patient Lennie Dannette Jerde
- Provider
- provider Trinity Mraz
- Payer
- payer No insurance
Record id
14e0014e-0650-d844-960c-40667d04158d