Claim total
$566.96
base $155.66 · payer covered $531.96
The visit
- Class
- Ambulatory
- Code
- 439740005
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2021-03-01
- Stop
- 2021-03-01
The parties
- Patient
- patient María del Carmen Berríos
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
016a1a5e-4450-7aaa-803c-a5b4d7ca16b3