Claim total
$12,894.85
base $127.17 · payer covered $12,859.85
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2022-04-27
- Stop
- 2022-04-28
The parties
- Patient
- patient Corliss Stormy Shanahan
- Provider
- provider Earle Keeling
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
13199f1b-9a57-6e58-b435-f00c78cdf200