Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2007-10-24
- Stop
- 2007-10-24
The parties
- Patient
- patient Craig Olin Cassin
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
255f4784-1651-1fb2-432d-4adb4cea567a