Claim total
$220.26
base $93.39 · payer covered $170.26
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2021-02-08
- Stop
- 2021-02-08
The parties
- Patient
- patient Jerome Gaylord Lueilwitz
- Provider
- provider Dee Ernser
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1326c004-812d-82f3-b7f7-937cbe642bb3