Claim total
$3,627.57
base $127.17 · payer covered $3,477.57
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2010-01-26
- Stop
- 2010-01-27
The parties
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-61c9-13ded2b3c319