Claim total
$5,682.65
base $127.17 · payer covered $4,546.12
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 1979-04-23
- Stop
- 1979-04-24
The parties
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
02b0534d-1cdc-7379-d2fd-e4734c26e129