Claim total
$515.93
base $93.39 · payer covered $412.75
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2013-08-25
- Stop
- 2013-08-25
The parties
- Patient
- patient Cristy Exie Pouros
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
034e20ab-aae7-ddf8-1009-4ecd763929e7