Claim total
$566.96
base $155.66 · payer covered $453.57
The visit
- Class
- Ambulatory
- Code
- 439740005
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2026-01-28
- Stop
- 2026-01-28
The parties
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
02b0534d-1cdc-7379-063f-32c97ed67a25