Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Shellfish735029006
- Start
- 2024-02-20
- Stop
- 2024-02-20
The parties
- Patient
- patient Barbra Davida Dickinson
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
35919240-5e22-43e8-0da5-e1f391e82f16