Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Osteoarthritis of knee239873007
- Start
- 2014-04-06
- Stop
- 2014-04-06
The parties
- Patient
- patient Roy Russ Bergstrom
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
13201b82-c84d-0844-36dd-5b5c6bcfa357