Claim total
$1,454.79
base $93.39 · payer covered $1,163.82
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2025-03-30
- Stop
- 2025-03-30
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-e95d-79ac2d9e72ea