Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bacterial sinusitis75498004
- Start
- 2017-05-30
- Stop
- 2017-05-30
The parties
- Patient
- patient Cleo Timothy Kemmer
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
04d0e486-8d5f-7bad-ba68-3e863ce4acc2