Claim total
$101.32
base $93.39 · payer covered $51.32
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bacterial sinusitis75498004
- Start
- 1995-01-31
- Stop
- 1995-01-31
The parties
- Patient
- patient Queen Sharika Fay
- Provider
- provider Altagracia Rippin
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
02c148c0-182c-a5fd-e37d-436ec428377e