Claim total
$183.75
base $93.39 · payer covered $183.75
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 1994-01-25
- Stop
- 1994-01-25
The parties
- Patient
- patient Lucie Shayla Metz
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0095f26f-6c35-6a9c-8f02-614404532ded