Claim total
$291.66
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-04-22
- Stop
- 2021-04-22
The parties
- Patient
- patient Allen Trent Mann
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
007bcc47-8ca5-7eab-6375-14067ac9f97f