Claim total
$93.42
base $93.39 · payer covered $74.73
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2025-12-03
- Stop
- 2025-12-03
The parties
- Patient
- patient Kim Edmundo Rolfson
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
03d7ab8f-b989-4d49-009f-d1c686025e2f