Claim total
$93.42
base $93.39 · payer covered $43.42
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2024-12-21
- Stop
- 2024-12-21
The parties
- Patient
- patient Gerardo Marvin Johns
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
01513b97-46a6-1303-acf4-8014eb0092c9