Claim total
$93.55
base $93.39 · payer covered $74.84
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2016-03-28
- Stop
- 2016-03-28
The parties
- Patient
- patient Kelvin Johnny Hirthe
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
292b5aae-02fc-4e2f-a04f-16a77742459b