Claim total
$2,623.46
base $155.66 · payer covered $4.30
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- —
- Start
- 2017-05-10
- Stop
- 2017-05-10
The parties
- Patient
- patient Bo Gino Murazik
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
003af57f-1886-144b-42ba-6e34bb4abe7b