Claim total
$631.25
base $93.39 · payer covered $596.25
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2023-04-12
- Stop
- 2023-04-12
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-bdbb-0bb659e75bbc