Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Streptococcal sore throat43878008
- Start
- 2018-11-15
- Stop
- 2018-11-15
The parties
- Patient
- patient Connie Buck Hane
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
02070c62-d383-1025-7d70-d87db2d23d7b