Claim total
$643.18
base $127.17 · payer covered $0.00
The visit
- Class
- Inpatient
- Code
- 32485007
- Reason
- —
- Start
- 2016-12-02
- Stop
- 2016-12-03
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Jerrod Roob
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
04384da7-7311-e99a-6a33-05c791269607