Claim total
$640.69
base $93.39 · payer covered $590.69
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2016-09-03
- Stop
- 2016-09-03
The parties
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
04424811-b26b-3a54-eeeb-920621a8e4ae