Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Outpatient
- Code
- 185345009
- Reason
- diagnosis concept Otitis media65363002
- Start
- 2025-09-06
- Stop
- 2025-09-06
The parties
- Patient
- patient Bettyann Wen Howell
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0257a216-88a6-e7f3-f8ec-7d8c6eff69fd