Claim total
$93.55
base $93.39 · payer covered $58.55
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2022-06-03
- Stop
- 2022-06-03
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
05c57aa9-c3e8-2f04-5a93-e4d7f99514c1