Claim total
$93.75
base $93.39 · payer covered $58.75
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2025-11-24
- Stop
- 2025-11-24
The parties
- Patient
- patient Adrian Isaiah Durgan
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
046903bc-0773-63cf-bd32-5f1d8cc747eb