Claim total
$1,328.29
base $93.39 · payer covered $1,178.29
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2000-06-01
- Stop
- 2000-06-01
The parties
- Patient
- patient Earl Jerome Schmidt
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0d968990-4e91-8a45-e9d3-d0f149778833