Claim total
$4,072.55
base $93.39 · payer covered $4,022.55
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Neoplasm of prostate126906006
- Start
- 1980-08-04
- Stop
- 1980-08-04
The parties
- Patient
- patient Guillermo Neil Dickinson
- Provider
- provider Andria Spinka
- Payer
- payer Medicaid
Record id
293f5dd0-3f7a-994e-47d5-4234b712e65b