Claim total
$103.58
base $93.39 · payer covered $68.58
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2023-12-02
- Stop
- 2023-12-02
The parties
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
021142be-3a32-af72-ed0a-179d78637cd6