Claim total
$835.68
base $93.39 · payer covered $785.68
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 1999-12-25
- Stop
- 1999-12-25
The parties
- Patient
- patient Reatha Victor O'Conner
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
0521a0be-ba7b-b4e6-f555-a81e5ba6618f