Claim total
$536.30
base $125.00 · payer covered $429.04
The visit
- Class
- Virtual
- Code
- 439740005
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2023-03-17
- Stop
- 2023-03-17
The parties
- Patient
- patient María del Carmen Berríos
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
016a1a5e-4450-7aaa-4d55-ccd580a7af5a