Claim total
$20,363.21
base $93.39 · payer covered $16,104.17
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Polyp of colon68496003
- Start
- 1994-11-08
- Stop
- 1994-11-08
The parties
- Patient
- patient Lucie Shayla Metz
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0095f26f-6c35-6a9c-c08e-fb2c302f5030