Claim total
$8,663.65
base $127.17 · payer covered $8,613.65
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2026-02-12
- Stop
- 2026-02-13
The parties
- Patient
- patient Starr Chun Hackett
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
2eeb7532-520e-d315-ee45-5386b8f8d7e1