Claim total
$978.26
base $155.66 · payer covered $978.26
The visit
- Class
- Ambulatory
- Code
- 424619006
- Reason
- diagnosis concept Complete miscarriage156073000
- Start
- 2007-05-25
- Stop
- 2007-05-25
The parties
- Patient
- patient Reatha Victor O'Conner
- Provider
- provider Morton Boyer
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Aetna
Record id
0521a0be-ba7b-b4e6-9a92-74133b50ee84