Claim total
$12,894.85
base $127.17 · payer covered $12,894.85
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2019-02-04
- Stop
- 2019-02-05
The parties
- Patient
- patient Leonor Raina Watsica
- Provider
- provider Tomas Fisher
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Humana
Record id
2e0dfd0f-820d-64e7-1133-15ff65f146c5