Claim total
$436.26
base $93.39 · payer covered $401.26
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2017-04-21
- Stop
- 2017-04-21
The parties
- Patient
- patient Efren Wilderman
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
0400ef40-232f-be7a-131e-c93b8bbed02e