Claim total
$3,627.57
base $127.17 · payer covered $3,592.57
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2021-09-13
- Stop
- 2021-09-14
The parties
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
021142be-3a32-af72-d5b3-860e40bd636f