Claim total
$772.40
base $93.39 · payer covered $717.11
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1961-08-30
- Stop
- 1961-08-30
The parties
- Patient
- patient Latasha Crist
- Provider
- provider Boris Lynch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0fc193c9-8970-9d72-c11d-8069cf34512b