Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Fracture subluxation of wrist263102004
- Start
- 1998-01-26
- Stop
- 1998-01-26
The parties
- Patient
- patient Lucie Shayla Metz
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0095f26f-6c35-6a9c-0572-eb2c7bea4860