Claim total
$108.71
base $93.39 · payer covered $73.71
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2015-09-04
- Stop
- 2015-09-04
The parties
- Patient
- patient Colby Wunsch
- Provider
- provider Cory Lynch
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Dual Eligible
Record id
02d10ce5-acf0-36ed-765d-0765ec0da1e3