Claim total
$93.39
base $93.39 · payer covered $56.03
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2016-02-21
- Stop
- 2016-02-21
The parties
- Patient
- patient Leo Ramon Wolf
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Aetna
Record id
0132d8d5-6e6e-d90f-c7f8-e1945ebe16bf