Claim total
$196,193.30
base $127.17 · payer covered $196,193.30
The visit
- Class
- Inpatient
- Code
- 305351004
- Start
- 2021-01-26
- Stop
- 2021-02-04
The parties
- Patient
- patient Leo Ramon Wolf
- Provider
- provider Jerrod Roob
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Aetna
Record id
0132d8d5-6e6e-d90f-f123-ed44f508928e