Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Wheat412071004
- Start
- 2026-03-31
- Stop
- 2026-03-31
The parties
- Patient
- patient Kendrick Jewell Jerde
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
020a56e3-5d79-5c72-37b3-4ccf2be0ef80