Claim total
$175.65
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Attempted suicide by suffocation287182007
- Start
- 2012-05-05
- Stop
- 2012-05-05
The parties
- Patient
- patient Williams Mauricio Boehm
- Provider
- provider Lynelle Ankunding
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
28bac566-789e-d07d-b3f5-55693c8e3ec5