Claim total
$11,299.85
base $127.17 · payer covered $11,249.85
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2017-01-10
- Stop
- 2017-01-11
The parties
- Patient
- patient Lillian Billye O'Conner
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
3248f34a-b42c-3b54-7321-e2e4fea46f82