Claim total
$610.08
base $93.39 · payer covered $575.08
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2006-02-17
- Stop
- 2006-02-17
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-23d3-5d200f29254b