Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Shellfish735029006
- Start
- 1992-09-10
- Stop
- 1992-09-10
The parties
- Patient
- patient Jewell Royal Krajcik
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
2f2181ad-74a6-3726-b004-167f7bc41598