Claim total
$5,750.95
base $127.17 · payer covered $5,700.95
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2019-05-27
- Stop
- 2019-05-28
The parties
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0f8011da-3f5b-ae5a-ebe8-56c2e306848b