Claim total
$2,623.46
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- —
- Start
- 2025-10-16
- Stop
- 2025-10-16
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Greta Gutmann
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Aetna
Record id
047ee4ec-c50b-b504-6e8c-7aa9b39d7c60