Claim total
$155.66
base $155.66 · payer covered $120.66
The visit
- Class
- Ambulatory
- Code
- 394701000
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2025-07-15
- Stop
- 2025-07-15
The parties
- Provider
- provider Silas Conn
- Payer
- payer Dual Eligible
Record id
014b9cfb-a71a-d032-3875-5ed256f0d315