Claim total
$273.83
base $155.66 · payer covered $238.83
The visit
- Class
- Ambulatory
- Code
- 410410006
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2024-03-28
- Stop
- 2024-03-28
The parties
- Patient
- patient María del Carmen Berríos
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
016a1a5e-4450-7aaa-3751-8fb0352f9180