Claim total
$3,383.79
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute viral pharyngitis195662009
- Start
- 2025-07-30
- Stop
- 2025-07-30
The parties
- Patient
- patient Kaycee Luanne Mohr
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
03ac889d-2da8-a492-289d-7c0e51c93dba