Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Osteoarthritis of knee239873007
- Start
- 2014-02-16
- Stop
- 2014-02-16
The parties
- Patient
- patient Brock Josiah Gaylord
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
2d5d1e2a-d4d9-a177-9eee-65456fbccfc3