Claim total
$842.99
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2013-03-15
- Stop
- 2013-03-15
The parties
- Patient
- patient Williams Mauricio Boehm
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
28bac566-789e-d07d-c559-ff39dcb1d215