Claim total
$250.89
base $155.66 · payer covered $200.71
The visit
- Class
- Ambulatory
- Code
- 410410006
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2025-02-27
- Stop
- 2025-02-27
The parties
- Patient
- patient María del Carmen Berríos
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
016a1a5e-4450-7aaa-aa61-a403a2ab1a94