Claim total
$239.00
base $155.66 · payer covered $189.00
The visit
- Class
- Ambulatory
- Code
- 410410006
- Reason
- diagnosis concept Malignant neoplasm of breast254837009
- Start
- 2020-03-15
- Stop
- 2020-03-15
The parties
- Patient
- patient María del Carmen Berríos
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
016a1a5e-4450-7aaa-5764-470ceb157935