Claim total
$893.81
base $93.39 · payer covered $715.03
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2013-10-25
- Stop
- 2013-10-25
The parties
- Patient
- patient Efren Wilderman
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0400ef40-232f-be7a-80e9-e66829436884