Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Wheat412071004
- Start
- 2010-08-25
- Stop
- 2010-08-25
The parties
- Patient
- patient Monnie Jesica Cremin
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
06e27cae-eea1-0277-776b-cc18b2eded28