Claim total
$93.49
base $93.39 · payer covered $58.49
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2025-03-26
- Stop
- 2025-03-26
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
0465c17f-66cb-2155-d239-bb545b0e6468