Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Osteoarthritis of hip239872002
- Start
- 2005-03-19
- Stop
- 2005-03-19
The parties
- Patient
- patient Millie Latrina Franecki
- Provider
- provider Trinidad Quitzon
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
293b5046-ff66-69d2-18fc-39360f682bfb