Claim total
$365.39
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2021-08-12
- Stop
- 2021-08-13
The parties
- Patient
- patient Temple Joe Beer
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
031e9e86-1ff9-e433-c2e0-1338b014cc0b