Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Glycine max256355007
- Start
- 2008-02-02
- Stop
- 2008-02-02
The parties
- Patient
- patient Latesha Olimpia Price
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Aetna
Record id
336a367a-9ecd-f668-2c25-1f3b475c0110