Claim total
$1,489.28
base $93.39 · payer covered $1,439.28
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Anemia271737000
- Start
- 2019-09-04
- Stop
- 2019-09-04
The parties
- Patient
- patient Mandy Christie Stracke
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
00aca497-ef30-85f4-84e3-791616f593cf