Claim total
$16,886.53
base $93.39 · payer covered $16,836.53
The visit
- Class
- Outpatient
- Code
- 185347001
- Reason
- diagnosis concept Non-small cell carcinoma of lung, TNM stage 1424132000
- Start
- 2011-09-26
- Stop
- 2011-09-26
The parties
- Patient
- patient Bambi Adah Koss
- Provider
- provider Darnell Reynolds
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
2d0c65c4-941d-c58c-03cf-6c3741d0325b