Claim total
$915.99
base $93.39 · payer covered $815.28
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute viral pharyngitis195662009
- Start
- 2018-11-30
- Stop
- 2018-11-30
The parties
- Patient
- patient Cristobal Dana Wolf
- Provider
- provider Lindsay Russel
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
016cc0d6-9a88-e8dc-0d1f-d4aeb4f7f365