Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Osteoarthritis of knee239873007
- Start
- 2002-02-13
- Stop
- 2002-02-13
The parties
- Patient
- patient Isaac Roberto Goyette
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
29b08593-21af-d81d-153f-fa125ad99157