Claim total
$219.95
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 2014-10-25
- Stop
- 2014-10-25
The parties
- Patient
- patient Mariana Ana Ornelas
- Provider
- provider Saundra Heller
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
11444f3f-edac-88ba-5bbf-29ce2569d7b5