Claim total
$15,068.25
base $155.66 · payer covered $6,591.13
The visit
- Class
- Outpatient
- Code
- 308335008
- Reason
- Contraception care389095005
- Start
- 2018-04-01
- Stop
- 2018-04-01
The parties
- Patient
- patient Xuan Collier
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
002d4429-df26-5797-6df5-568e1befb5b1