Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Shellfish735029006
- Start
- 1924-07-30
- Stop
- 1924-07-30
The parties
- Patient
- patient Lucie Shayla Metz
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0095f26f-6c35-6a9c-eb97-718492684a28