Claim total
$975.97
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1994-05-22
- Stop
- 1994-05-23
The parties
- Patient
- patient Mike Brendon Hackett
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
048bde62-95d9-bb18-8402-4b2b8442d8b2