Claim total
$443.00
base $93.39 · payer covered $168.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2018-01-23
- Stop
- 2018-01-23
The parties
- Patient
- patient Amalia Ana María Soliz
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
007eb971-e9c1-129f-5eb6-2dff53a40dbe