Claim total
$9,994.84
base $93.39 · payer covered $9,944.84
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Neoplasm of prostate126906006
- Start
- 2015-03-31
- Stop
- 2015-03-31
The parties
- Patient
- patient Marcelo Roland Daniel
- Provider
- provider Hollie Sawayn
- Payer
- payer Medicaid
Record id
172af60a-c1b7-eaec-afa1-50b5a12411a0