Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Wheat412071004
- Start
- 1977-01-03
- Stop
- 1977-01-03
The parties
- Patient
- patient Ellena Eartha Cassin
- Provider
- provider Madalyn Konopelski
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
2c69d807-451d-7a16-c661-5bc545e435ea