Claim total
$93.60
base $93.39 · payer covered $58.60
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2023-06-26
- Stop
- 2023-06-26
The parties
- Patient
- patient María del Carmen Berríos
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
016a1a5e-4450-7aaa-e146-cc55a1ef55b9