Claim total
$536.30
base $125.00 · payer covered $429.04
The visit
- Class
- Virtual
- Code
- 439740005
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2021-04-07
- Stop
- 2021-04-07
The parties
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
02b0534d-1cdc-7379-3a4c-e988d4bf5800