Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185349003
- Start
- 2018-08-24
- Stop
- 2018-08-24
The parties
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00efc86d-40fa-9fdc-ccfa-539febf66ef8