Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 1994-11-16
- Stop
- 1994-11-16
The parties
- Patient
- patient Winford Jermaine Bode
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
32a7c5c0-d154-0176-effa-01acbb545aa0