Claim total
$115.25
base $93.39 · payer covered $92.20
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2017-01-24
- Stop
- 2017-01-24
The parties
- Patient
- patient Amalia Ana María Soliz
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
007eb971-e9c1-129f-1717-19e9b4e8cb61