Claim total
$504.69
base $93.39 · payer covered $319.09
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Dependent drug abuse6525002
- Start
- 2025-10-26
- Stop
- 2025-10-26
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
04384da7-7311-e99a-8ac1-fa0c2927857f