Claim total
$703.97
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2026-09-07
- Stop
- 2026-09-07
The parties
- Patient
- patient Otha Jewel Ankunding
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
Record id
01bd7d75-9405-280a-2e2b-6b28bf053f99