Claim total
$100.30
base $93.39 · payer covered $80.23
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2004-07-25
- Stop
- 2004-07-25
The parties
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
02b0534d-1cdc-7379-5310-0358ca238f63