Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Wheat412071004
- Start
- 1998-11-08
- Stop
- 1998-11-08
The parties
- Patient
- patient Antonia Sherwood Schmitt
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1888bd1d-48de-7570-540c-6a076820e7ca