Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Outpatient
- Code
- 185347001
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-02-06
- Stop
- 2014-02-07
The parties
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
0177a0d4-f7b6-3393-ad14-b7ba3d1c12b5