Claim total
$219.95
base $93.39 · payer covered $175.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 2003-06-25
- Stop
- 2003-06-25
The parties
- Patient
- patient Donny Wilfred Ruecker
- Provider
- provider Hazel Effertz
- Payer
- payer Medicare
Record id
0054427e-44d7-94b2-ede4-811b342f701b