Claim total
$101.32
base $93.39 · payer covered $51.32
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bacterial sinusitis75498004
- Start
- 2007-05-14
- Stop
- 2007-05-14
The parties
- Patient
- patient Cleo Timothy Kemmer
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
04d0e486-8d5f-7bad-54d4-e785031b97b0