Claim total
$220.26
base $93.39 · payer covered $170.26
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2021-01-27
- Stop
- 2021-01-27
The parties
- Patient
- patient Lonna Shaina Lang
- Provider
- provider Dee Ernser
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
333a9dcf-5fad-a3e0-5d1a-513c8bb548ed