Claim total
$224.67
base $93.39 · payer covered $174.67
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2021-05-05
- Stop
- 2021-05-05
The parties
- Patient
- patient Courtney Clifton Roberts
- Provider
- provider Dee Ernser
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
15a85dbf-71f7-c524-ee71-00636607970b