Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Outpatient
- Code
- 185345009
- Reason
- diagnosis concept Otitis media65363002
- Start
- 1968-03-17
- Stop
- 1968-03-17
The parties
- Patient
- patient Ronnie Ina Gusikowski
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
003b30a0-7fd2-f42c-ae74-023fc15f58f8