Claim total
$220.26
base $93.39 · payer covered $170.26
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Suspected disease caused by Severe acute respiratory coronavirus 2840544004
- Start
- 2020-06-14
- Stop
- 2020-06-14
The parties
- Patient
- patient Clay Brandon Schuppe
- Provider
- provider Dee Ernser
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
3310e903-3aa7-ca72-8d00-9808051003e0