Claim total
$75.00
base $75.00 · payer covered $0.00
The visit
- Class
- Virtual
- Code
- 185347001
- Reason
- Eggs (edible)102263004
- Start
- 2026-01-30
- Stop
- 2026-01-30
The parties
- Patient
- patient Janie Ranae Botsford
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
041efb3a-8e81-3ea8-3361-c5ac2e4d83e1