Claim total
$223.80
base $93.39 · payer covered $173.80
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2020-12-14
- Stop
- 2020-12-14
The parties
- Patient
- patient Leilani Melany Kuvalis
- Provider
- provider Kiyoko Predovic
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
222da595-6329-b84e-8f65-981805abba31