Claim total
$640.69
base $93.39 · payer covered $590.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2020-04-14
- Stop
- 2020-04-14
The parties
- Patient
- patient Sherill Ingeborg Wyman
- Provider
- provider Bethanie Wintheiser
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
03eccc4c-a1c4-14ad-c1fd-aaab3367a2c1