Claim total
$5,489.30
base $93.39 · payer covered $5,439.30
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- Screening for malignant neoplasm of colon275978004
- Start
- 2020-04-10
- Stop
- 2020-04-10
The parties
- Patient
- patient Connie Buck Hane
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
02070c62-d383-1025-dbaa-79744dabb16d