Claim total
$260.05
base $127.17 · payer covered $210.05
The visit
- Class
- Inpatient
- Code
- 32485007
- Reason
- —
- Start
- 2021-12-21
- Stop
- 2021-12-22
The parties
- Patient
- patient Nicky Kristi Wiegand
- Provider
- provider Leo Marquardt
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
0358d022-e88b-b208-f676-ba13d4da98a2