Claim total
$1,710.99
base $93.39 · payer covered $1,368.80
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2018-09-09
- Stop
- 2018-09-09
The parties
- Patient
- patient Cristy Exie Pouros
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
034e20ab-aae7-ddf8-a538-fa5a52e35901