Claim total
$93.83
base $93.39 · payer covered $75.06
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2019-10-30
- Stop
- 2019-10-30
The parties
- Patient
- patient Kim Edmundo Rolfson
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
03d7ab8f-b989-4d49-77cc-ca8597c793b1