Claim total
$4,203.60
base $93.39 · payer covered $2,196.48
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2012-08-18
- Stop
- 2012-08-18
The parties
- Patient
- patient Tanner Emile Stehr
- Provider
- provider Kiyoko Predovic
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Anthem
Record id
04510aef-c62e-a77f-6505-43f590c97c1c