Claim total
$1,257.64
base $93.39 · payer covered $821.47
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1988-05-30
- Stop
- 1988-05-30
The parties
- Patient
- patient Jeanmarie Jann Bogisich
- Provider
- provider Trinity Mraz
- Payer
- payer Medicare
Record id
17e1c4cb-44e4-7484-95e3-f8b6689091f1