Claim total
$2,225.82
base $93.39 · payer covered $2,075.82
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute viral pharyngitis195662009
- Start
- 2019-06-23
- Stop
- 2019-06-23
The parties
- Patient
- patient Connie Buck Hane
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
02070c62-d383-1025-89ed-b5242e55ea4c