Claim total
$1,945.18
base $93.39 · payer covered $1,369.74
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1999-06-14
- Stop
- 1999-06-15
The parties
- Patient
- patient Garland Thiel
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
02ec371b-21cc-5c35-c15b-14fb7f315de9