Claim total
$631.25
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2018-10-18
- Stop
- 2018-10-18
The parties
- Patient
- patient Britany Kerrie West
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
02a95708-afbd-de6b-4878-64ec6cde021a