Claim total
$219.95
base $93.39 · payer covered $175.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- —
- Start
- 2018-03-27
- Stop
- 2018-03-27
The parties
- Patient
- patient Kazuko Tamie Tillman
- Provider
- provider Ozella Goodwin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
3487d097-833b-5fcf-2d3b-2f89a7383cba