Claim total
$110.71
base $93.39 · payer covered $88.57
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2024-10-13
- Stop
- 2024-10-13
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-aad5-98d8ecff0bc9