Claim total
$220.85
base $93.39 · payer covered $170.85
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2021-08-24
- Stop
- 2021-08-24
The parties
- Patient
- patient Gwyn Priscilla Spinka
- Provider
- provider Dee Ernser
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2bcfe7e7-608a-8690-f119-eb37268ade48