Claim total
$5,906.86
base $127.17 · payer covered $5,856.86
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 1955-05-15
- Stop
- 1955-05-16
The parties
- Patient
- patient Toshiko Sybil King
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
106257f3-21d9-7a09-7dd5-02ffd782412c