Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Glycine max256355007
- Start
- 2021-03-28
- Stop
- 2021-03-28
The parties
- Patient
- patient Kaley Trena Schuppe
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Aetna
Record id
0bb99e9f-e993-1284-61d4-ed4aa75cb557