Claim total
$1,463.29
base $93.39 · payer covered $877.97
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2013-12-22
- Stop
- 2013-12-22
The parties
- Patient
- patient Xuan Collier
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
002d4429-df26-5797-1fff-a536923f1f02