Claim total
$93.50
base $93.39 · payer covered $93.50
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 1992-09-01
- Stop
- 1992-09-01
The parties
- Patient
- patient Lucie Shayla Metz
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0095f26f-6c35-6a9c-0327-0104d4d6819f