Claim total
$3,627.57
base $127.17 · payer covered $2,176.54
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2023-12-23
- Stop
- 2023-12-24
The parties
- Patient
- patient Suzy Alyson Gutmann
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
172e3d48-7ef1-d07b-57da-9f1653d93674