Claim total
$3,447.07
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute infective cystitis307426000
- Start
- 2017-12-24
- Stop
- 2017-12-24
The parties
- Provider
- provider Chance Wisoky
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Humana
Record id
032df52f-9699-4603-e033-95e5668a82fa