Claim total
$104.66
base $93.39 · payer covered $69.66
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 1967-08-20
- Stop
- 1967-08-20
The parties
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
02b0534d-1cdc-7379-a3f2-2e51a68f01b4