Claim total
$1,597.16
base $93.39 · payer covered $1,562.16
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2014-03-19
- Stop
- 2014-03-19
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Boris Lynch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
0465c17f-66cb-2155-b119-a9608ccdbc11