Claim total
$3,447.07
base $93.39 · payer covered $3,397.07
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute infective cystitis307426000
- Start
- 1999-04-25
- Stop
- 1999-04-25
The parties
- Provider
- provider Clyde Beier
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
04424811-b26b-3a54-2c7f-9ff2dd98a551