Claim total
$519.81
base $93.39 · payer covered $415.85
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2017-09-03
- Stop
- 2017-09-03
The parties
- Patient
- patient Cristy Exie Pouros
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
034e20ab-aae7-ddf8-c2f5-00467d23d64d