Claim total
$1,078.92
base $93.39 · payer covered $863.13
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2018-08-23
- Stop
- 2018-08-23
The parties
- Patient
- patient Lamar Mark Connelly
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
050746ba-be7e-c592-9d96-e11621b1ab8a