Claim total
$435.04
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2016-07-26
- Stop
- 2016-07-26
The parties
- Patient
- patient Eulah Avril Aufderhar
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
02aef5a1-9ba3-229b-d833-4d8764456ad4