Claim total
$1,463.29
base $93.39 · payer covered $460.14
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2009-04-24
- Stop
- 2009-04-24
The parties
- Patient
- patient Doug Dewayne Hauck
- Provider
- provider Wes Jast
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Anthem
Record id
0fa83559-a261-6546-ae23-720bcb5a5fff