Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Wheat412071004
- Start
- 1989-05-21
- Stop
- 1989-05-21
The parties
- Patient
- patient Chang Larry Hermiston
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
3a43a35d-fb85-2922-3225-364b1754384b