Claim total
$978.26
base $155.66 · payer covered $978.26
The visit
- Class
- Ambulatory
- Code
- 169762003
- Reason
- —
- Start
- 2022-01-09
- Stop
- 2022-01-09
The parties
- Provider
- provider Joshua Dickens
- Care site
- care site FAIRVIEW HEALTH SERVICES
Record id
05f1dbc7-3ebc-37ee-88c8-460f4d2821b8