Claim total
$703.97
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2024-01-21
- Stop
- 2024-01-22
The parties
- Patient
- patient Heriberto Bennie Walsh
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
02b5c001-4bdb-16d2-6376-c42f9d5e00b0