Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Glycine max256355007
- Start
- 1964-08-13
- Stop
- 1964-08-13
The parties
- Patient
- patient Mariana Ana Ornelas
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
11444f3f-edac-88ba-9007-d4e39b736fd6