Claim total
$93.39
base $93.39 · payer covered $58.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Start
- 2020-09-29
- Stop
- 2020-09-30
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
05c57aa9-c3e8-2f04-388d-e409b8cda07d