Claim total
$221.59
base $93.39 · payer covered $71.59
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2021-08-15
- Stop
- 2021-08-15
The parties
- Patient
- patient Vern Isreal White
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
37f95691-9da2-3eb9-415e-d48c5f14a090