Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-09-20
- Stop
- 2021-09-20
The parties
- Patient
- patient Bo Gino Murazik
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
003af57f-1886-144b-8b5a-939754e45839