Claim total
$846.34
base $93.39 · payer covered $846.34
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2015-10-19
- Stop
- 2015-10-19
The parties
- Patient
- patient Zofia Shakira Wilkinson
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
20a24b42-e25a-2edc-d136-6ba0d0c7601e