Claim total
$219.95
base $93.39 · payer covered $175.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 2018-05-13
- Stop
- 2018-05-13
The parties
- Patient
- patient Irving Noah Zboncak
- Provider
- provider Leta Sipes
- Payer
- payer Medicare
Record id
2f7a09c8-cdf2-9b2d-f868-83fe7260b44a