Claim total
$772.40
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2012-09-26
- Stop
- 2012-09-26
The parties
- Patient
- patient Keira Tona Smith
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Aetna
Record id
2ee18a5a-7976-7950-c01c-64d55e8f67f5