Claim total
$219.95
base $93.39 · payer covered $184.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- —
- Start
- 2024-01-10
- Stop
- 2024-01-10
The parties
- Patient
- patient Gilbert Ivan Bauch
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
0c35b5fe-1f15-f1f3-af8e-7df008ba3c0d