Claim total
$291.66
base $155.66 · payer covered $291.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2021-03-16
- Stop
- 2021-03-16
The parties
- Patient
- patient Eulah Avril Aufderhar
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
02aef5a1-9ba3-229b-1493-4ae72898bafe