Claim total
$223.68
base $93.39 · payer covered $173.68
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2020-12-03
- Stop
- 2020-12-03
The parties
- Patient
- patient Raleigh Marlon Quitzon
- Provider
- provider Nanette Haley
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
36d18d55-3a3e-3ebd-6e3e-c08595a8e5cf