Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Outpatient
- Code
- 185345009
- Reason
- diagnosis concept Otitis media65363002
- Start
- 2019-08-22
- Stop
- 2019-08-22
The parties
- Patient
- patient Abdul Sammie Spencer
- Provider
- provider Aisha Corwin
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
009b9fb1-8515-f33d-f41d-a30c962e0944