Claim total
$3,627.57
base $127.17 · payer covered $3,577.57
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2007-10-19
- Stop
- 2007-10-20
The parties
- Patient
- patient Eulah Avril Aufderhar
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
02aef5a1-9ba3-229b-b6c5-c933352caef1