Claim total
$566.96
base $155.66 · payer covered $531.96
The visit
- Class
- Outpatient
- Code
- 698314001
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2021-08-31
- Stop
- 2021-08-31
The parties
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
021142be-3a32-af72-47ec-37c623c9edb0