Claim total
$435.04
base $93.39 · payer covered $348.03
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2025-04-14
- Stop
- 2025-04-14
The parties
- Patient
- patient Phylis Elenora Cassin
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0400c40b-e8b5-c779-863b-b73ac61c69f6