Claim total
$2,014.03
base $93.39 · payer covered $1,611.22
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2021-10-09
- Stop
- 2021-10-10
The parties
- Patient
- patient Tanner Emile Stehr
- Provider
- provider Miyoko Botsford
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
04510aef-c62e-a77f-fc97-f0f0e6f3253c