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
- 2018-06-19
- Stop
- 2018-06-20
The parties
- Patient
- patient Arlette Soledad Cremin
- Provider
- provider Julee Jones
- Payer
- payer Medicaid
Record id
1af9c94d-34ef-178e-2419-19dcc2399af5