Claim total
$80.92
base $75.00 · payer covered $30.92
The visit
- Class
- Virtual
- Code
- 185317003
- Reason
- —
- Start
- 2017-05-02
- Stop
- 2017-05-02
The parties
- Patient
- patient Cleo Timothy Kemmer
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
04d0e486-8d5f-7bad-51a9-1bbb0443c1e4