Claim total
$779.71
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1996-06-30
- Stop
- 1996-06-30
The parties
- Patient
- patient Cristy Exie Pouros
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
034e20ab-aae7-ddf8-a5eb-cd18a0e43b27