Claim total
$220.32
base $93.39 · payer covered $170.32
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2020-08-31
- Stop
- 2020-08-31
The parties
- Patient
- patient Lucina Cole
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
0832d9ad-468a-2b63-dcbc-b319892ed54e