Claim total
$701.84
base $93.39 · payer covered $666.84
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2018-01-27
- Stop
- 2018-01-27
The parties
- Provider
- provider Antonetta Lubowitz
- Payer
- payer Dual Eligible
Record id
2d46927f-3540-85ed-c02c-e29682984c99