Claim total
$836.90
base $93.39 · payer covered $669.51
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2025-07-23
- Stop
- 2025-07-23
The parties
- Patient
- patient Hans Marion Kuvalis
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
107d0674-dc76-cfa0-5d4e-25eb99a517d8