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
- 2022-07-07
- Stop
- 2022-07-08
The parties
- Patient
- patient An Wenona Rau
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
04682680-f77d-0a00-f013-eec6a315716e