Claim total
$93.42
base $93.39 · payer covered $58.42
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2025-12-13
- Stop
- 2025-12-13
The parties
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
021142be-3a32-af72-8d20-8128000e9638