Claim total
$504.69
base $93.39 · payer covered $469.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2021-01-09
- Stop
- 2021-01-09
The parties
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
021142be-3a32-af72-60f6-5bd4168d45c2