Claim total
$1,206.94
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Streptococcal sore throat43878008
- Start
- 2020-03-09
- Stop
- 2020-03-09
The parties
- Patient
- patient Carlyn Donita Ortiz
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
00e3929f-91f8-0715-ec72-400abbeade55