Claim total
$566.96
base $155.66 · payer covered $516.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2023-06-11
- Stop
- 2023-06-11
The parties
- Patient
- patient Jamison Spencer
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
322af8b2-a1f4-5e36-d996-402d268ce126