Claim total
$219.29
base $93.39 · payer covered $131.57
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2019-12-09
- Stop
- 2019-12-09
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-bbfa-881d024880f7