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
- 2025-02-04
- Stop
- 2025-02-04
The parties
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
02b0534d-1cdc-7379-6973-2e002620cfe8