Claim total
$114.14
base $93.39 · payer covered $91.31
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2016-10-12
- Stop
- 2016-10-12
The parties
- Patient
- patient Kim Edmundo Rolfson
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
03d7ab8f-b989-4d49-42e0-6fca7891d94b