Claim total
$906.27
base $93.39 · payer covered $856.27
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1986-10-17
- Stop
- 1986-10-17
The parties
- Patient
- patient Judy Yundt
- Provider
- provider Celesta Shields
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Medicaid
Record id
28694091-a035-e362-6947-0bba096d4a2b