Claim total
$101.32
base $93.39 · payer covered $51.32
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Sinusitis36971009
- Start
- 1992-07-26
- Stop
- 1992-07-26
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
05c57aa9-c3e8-2f04-3be0-c497a7640630