Claim total
$3,627.57
base $127.17 · payer covered $3,577.57
The visit
- Class
- Inpatient
- Code
- 305408004
- Reason
- diagnosis concept Sterilization requested183996000
- Start
- 2021-11-24
- Stop
- 2021-11-25
The parties
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
32e00f15-89ac-2f36-a498-a0c4b757beab