Claim total
$975.97
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2015-12-16
- Stop
- 2015-12-16
The parties
- Patient
- patient Nona Samara Gleichner
- Provider
- provider Leta Sipes
- Payer
- payer Humana
Record id
0042ca65-dd9d-7221-b8e3-5a6ae0ec1964