Claim total
$254.07
base $93.39 · payer covered $219.07
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 1973-05-05
- Stop
- 1973-05-05
The parties
- Patient
- patient Gerardo Marvin Johns
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
01513b97-46a6-1303-905e-9929d6c1293e