Claim total
$221.46
base $155.66 · payer covered $177.17
The visit
- Class
- Ambulatory
- Code
- 410410006
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2022-04-24
- Stop
- 2022-04-24
The parties
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
02b0534d-1cdc-7379-03ad-e92cdd04f9df