Claim total
$4,892.10
base $127.17 · payer covered $4,842.10
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2010-07-28
- Stop
- 2010-07-29
The parties
- Patient
- patient Jacqui Bess Baumbach
- Provider
- provider Daryl Farrell
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
019cda32-2557-7f65-9a52-0db7dfd74750