Claim total
$12,894.85
base $127.17 · payer covered $12,844.85
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2021-07-10
- Stop
- 2021-07-11
The parties
- Patient
- patient Kristin Latrice Keebler
- Provider
- provider Julee Jones
- Payer
- payer Medicaid
Record id
2ce0929e-53d1-6ae1-dd53-888792c90351