Claim total
$715.72
base $93.39 · payer covered $665.72
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2015-10-16
- Stop
- 2015-10-16
The parties
- Patient
- patient Debbi Steven McLaughlin
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
358791ea-ef95-e7ec-2c9f-ab53c0b5238b