Claim total
$222.80
base $93.39 · payer covered $187.80
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2020-12-13
- Stop
- 2020-12-13
The parties
- Patient
- patient Tisa Joya Stoltenberg
- Provider
- provider Tiffany Smitham
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Dual Eligible
Record id
2debd169-2d62-f488-7137-3f6cff5c293c