Claim total
$3,447.07
base $93.39 · payer covered $3,397.07
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute infective cystitis307426000
- Start
- 2015-04-10
- Stop
- 2015-04-10
The parties
- Patient
- patient Peg Tresa Cummerata
- Provider
- provider Silvana Weber
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
04fb4e35-41c7-7592-00e3-0d82cae4be31