Claim total
$1,212.29
base $155.66 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- Contraception care389095005
- Start
- 2019-03-21
- Stop
- 2019-03-21
The parties
- Patient
- patient Cyndi Tromp
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
01936333-6290-e7a2-fe19-35336ee1f795