Claim total
$2,034.89
base $155.66 · payer covered $2,034.89
The visit
- Class
- Ambulatory
- Code
- 169762003
- Reason
- —
- Start
- 2018-07-30
- Stop
- 2018-07-30
The parties
- Patient
- patient Aubrey Mattie Turcotte
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
01ad68d8-96ec-fcdf-80dc-3e58c31a5be1