Claim total
$220.64
base $93.39 · payer covered $70.64
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2020-12-24
- Stop
- 2020-12-24
The parties
- Patient
- patient Basil Josef Bosco
- Provider
- provider Wes Jast
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
03478e49-59cf-7140-e39a-8e2df6f1a68c