Claim total
$1,105.83
base $93.39 · payer covered $884.65
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2013-01-14
- Stop
- 2013-01-14
The parties
- Patient
- patient Denny Rodrigo Cole
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
01d0b380-425a-3ac7-cd2e-962ce1b7c615