Claim total
$776.18
base $93.39 · payer covered $620.93
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2019-10-21
- Stop
- 2019-10-22
The parties
- Patient
- patient Garland Thiel
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
02ec371b-21cc-5c35-1824-053de069441b