Claim total
$1,106.27
base $93.39 · payer covered $1,071.27
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2024-07-12
- Stop
- 2024-07-12
The parties
- Patient
- patient Kizzy Blondell Hermann
- Provider
- provider Walter Volkman
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
0fa13c65-5aee-f679-0212-ec734bd5f64f