Claim total
$504.69
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Dependent drug abuse6525002
- Start
- 2017-03-25
- Stop
- 2017-03-25
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
04384da7-7311-e99a-3407-d56af36a791f