Claim total
$4,043.45
base $127.17 · payer covered $3,993.45
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2019-11-30
- Stop
- 2019-12-01
The parties
- Patient
- patient Marni Pinkie Graham
- Provider
- provider Julee Jones
- Payer
- payer Medicaid
Record id
335e3613-e55f-e961-9f48-cf17c5501fc5