Claim total
$1,241.83
base $93.39 · payer covered $993.45
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2026-02-22
- Stop
- 2026-02-22
The parties
- Patient
- patient Cristy Exie Pouros
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
034e20ab-aae7-ddf8-fa0f-0333dbfc11a6