Claim total
$640.69
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2015-12-04
- Stop
- 2015-12-04
The parties
- Patient
- patient Agnus Jaskolski
- Provider
- provider Laurence Mosciski
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Humana
Record id
00bd0ed6-396a-5390-ccc5-74f9c36a42c1