Claim total
$3,627.57
base $127.17 · payer covered $3,577.57
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2019-05-04
- Stop
- 2019-05-05
The parties
- Patient
- patient Kittie Olevia Walter
- Provider
- provider Vanessa Prosacco
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
178c01a3-2a21-ca97-4e26-a484c4418978