Claim total
$42,045.35
base $76.30 · payer covered $42,010.35
The visit
- Class
- Inpatient
- Code
- 185347001
- Reason
- diagnosis concept Primary small cell malignant neoplasm of lung, TNM stage 167811000119102
- Start
- 2020-01-16
- Stop
- 2020-01-22
The parties
- Patient
- patient Eulah Avril Aufderhar
- Provider
- provider Mathew Jones
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
02aef5a1-9ba3-229b-1706-d9da2a26c7b8