Claim total
$9,392.03
base $93.39 · payer covered $7,513.61
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1996-08-24
- Stop
- 1996-08-24
The parties
- Patient
- patient Carylon Erlinda Bergnaum
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0aff79a2-450d-907e-f51d-bf3a4fdf694c