Claim total
$629.16
base $93.39 · payer covered $594.16
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2017-10-09
- Stop
- 2017-10-09
The parties
- Patient
- patient Adrian Isaiah Durgan
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
046903bc-0773-63cf-98fd-1ea3eb7dfb4a