Claim total
$12,894.85
base $127.17 · payer covered $12,844.85
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2017-12-05
- Stop
- 2017-12-06
The parties
- Patient
- patient Zenia Tegan Nolan
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0f1bcaa4-de3d-14e5-4bf3-61d54f1ba64b