Claim total
$1,099.70
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute viral pharyngitis195662009
- Start
- 2025-09-07
- Stop
- 2025-09-07
The parties
- Patient
- patient Jeramy Diego Keebler
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
024ea619-fff0-c0e8-fbe7-895ea71e1150