Claim total
$846.34
base $93.39 · payer covered $677.07
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2016-10-04
- Stop
- 2016-10-04
The parties
- Patient
- patient Nanci Lourie Rath
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
019cb7db-9e62-def9-88bd-548cd978a495