Claim total
$106.60
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 1973-11-05
- Stop
- 1973-11-05
The parties
- Patient
- patient Bo Gino Murazik
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
003af57f-1886-144b-5eac-45ad40dd4aa2