Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Fracture of clavicle58150001
- Start
- 2018-06-10
- Stop
- 2018-06-10
The parties
- Patient
- patient Onie Shannon Borer
- Provider
- provider Wes Jast
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Cigna Health
Record id
006af299-d813-2b4f-7b04-6fdaf675bb51