Claim total
$536.15
base $93.39 · payer covered $501.15
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- —
- Start
- 2011-04-01
- Stop
- 2011-04-01
The parties
- Patient
- patient Jewel Chi Harris
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Dual Eligible
Record id
05c57aa9-c3e8-2f04-25bf-423d29654dd0