Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Wheat412071004
- Start
- 2009-07-07
- Stop
- 2009-07-07
The parties
- Patient
- patient Amado Antwan Botsford
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
2217599d-1482-7c06-940f-3daf41c6bb07