Claim total
$8,479.45
base $93.39 · payer covered $8,329.45
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2004-09-10
- Stop
- 2004-09-12
The parties
- Patient
- patient María del Carmen Berríos
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
016a1a5e-4450-7aaa-f16e-82f6097fac41