Claim total
$220.73
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2020-12-13
- Stop
- 2020-12-13
The parties
- Patient
- patient Jeffie Vivan Lowe
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer UnitedHealthcare
Record id
357b1f09-8ef7-8091-9b47-92346c507c44