Claim total
$224.67
base $93.39 · payer covered $74.67
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2020-12-04
- Stop
- 2020-12-04
The parties
- Patient
- patient Kam Ching Pollich
- Provider
- provider Bethanie Wintheiser
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0681ce4b-c984-7822-a47b-f2a6ba10925a