Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Fish735971005
- Start
- 1995-06-05
- Stop
- 1995-06-05
The parties
- Patient
- patient Rosario Lucia Avilés
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
199a763e-853b-2729-2ad2-e80dcf38ef9e