Claim total
$222.21
base $93.39 · payer covered $72.21
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2020-06-23
- Stop
- 2020-06-23
The parties
- Patient
- patient Angelica Yetta Goyette
- Provider
- provider Dee Ernser
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2c2210e3-e57b-0933-1e38-239d15142fd9