Claim total
$1,108.90
base $93.39 · payer covered $665.34
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2015-05-04
- Stop
- 2015-05-04
The parties
- Patient
- patient Bo Gino Murazik
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
003af57f-1886-144b-7666-814c4ff0df87