Claim total
$6,751.80
base $155.66 · payer covered $6,701.80
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2024-08-03
- Stop
- 2024-08-03
The parties
- Patient
- patient Cristobal Dana Wolf
- Provider
- provider Richard Ledner
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
016cc0d6-9a88-e8dc-26c7-cc489d9387b9