Claim total
$6,025.65
base $93.39 · payer covered $4,820.51
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2024-12-06
- Stop
- 2024-12-06
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
04384da7-7311-e99a-91d9-5f0cd1917634