Claim total
$264.21
base $93.39 · payer covered $229.21
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2018-02-14
- Stop
- 2018-02-14
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
0465c17f-66cb-2155-abde-221235a2a9a7