Claim total
$728.51
base $93.39 · payer covered $582.81
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2025-06-20
- Stop
- 2025-06-20
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
05c57aa9-c3e8-2f04-408d-99227da7c1f9