Claim total
$710.34
base $93.39 · payer covered $660.34
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2021-05-11
- Stop
- 2021-05-11
The parties
- Patient
- patient An Wenona Rau
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
04682680-f77d-0a00-3389-10467ab998ca