Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Wheat412071004
- Start
- 2004-03-05
- Stop
- 2004-03-05
The parties
- Patient
- patient Thersa Carisa Connelly
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
282d5f3b-9341-0a9d-449a-a967fa9bf9cf