Claim total
$10,255.44
base $76.30 · payer covered $10,220.44
The visit
- Class
- Inpatient
- Code
- 185347001
- Reason
- diagnosis concept Malignant neoplasm of colon363406005
- Start
- 2012-08-26
- Stop
- 2012-08-28
The parties
- Patient
- patient Solomon Amado Purdy
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
1e6fa6a9-1f41-5355-c285-dc76b4b48881