Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Start
- 2018-04-22
- Stop
- 2018-04-22
The parties
- Patient
- patient Courtney Clifton Roberts
- Provider
- provider Boris Lynch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
15a85dbf-71f7-c524-7329-aaccb8d12f7d