Claim total
$504.69
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2019-09-24
- Stop
- 2019-09-24
The parties
- Patient
- patient Janie Ranae Botsford
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
041efb3a-8e81-3ea8-bb57-91ecc7db095c