Claim total
$219.95
base $93.39 · payer covered $169.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- —
- Start
- 2012-01-27
- Stop
- 2012-01-27
The parties
- Patient
- patient Marcelo Roland Daniel
- Provider
- provider Elna Johnston
- Payer
- payer Medicaid
Record id
172af60a-c1b7-eaec-1ff8-07aa3468d40e