Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2020-09-20
- Stop
- 2020-09-20
The parties
- Patient
- patient Cristy Exie Pouros
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
034e20ab-aae7-ddf8-0d6c-85cc12ef3fc8