Claim total
$835.68
base $93.39 · payer covered $785.68
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1979-02-10
- Stop
- 1979-02-10
The parties
- Patient
- patient Grazyna Anjanette Lowe
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
1a5a8158-2d65-1c33-320a-0ec7f533a7d8