Claim total
$978.26
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 169762003
- Reason
- —
- Start
- 2024-07-30
- Stop
- 2024-07-30
The parties
- Provider
- provider Lady Frami
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Humana
Record id
032df52f-9699-4603-0ea2-f23c5f103d4c