Claim total
$1,222.95
base $93.39 · payer covered $1,172.95
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2024-07-20
- Stop
- 2024-07-20
The parties
- Patient
- patient Bernard Gleichner
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
04317637-3b9f-f5e4-efe3-7ce819a3e8c8