Claim total
$121.64
base $93.39 · payer covered $97.31
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2023-08-29
- Stop
- 2023-08-29
The parties
- Patient
- patient Amalia Ana María Soliz
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
007eb971-e9c1-129f-6744-61640857fab5