Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Osteoarthritis of hip239872002
- Start
- 2024-12-03
- Stop
- 2024-12-03
The parties
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
04424811-b26b-3a54-4519-0b4f3ad4b3dd