Claim total
$5,613.06
base $75.00 · payer covered $5,563.06
The visit
- Class
- Virtual
- Code
- 185347001
- Reason
- diagnosis concept Child attention deficit disorder192127007
- Start
- 2024-01-17
- Stop
- 2024-01-17
The parties
- Patient
- patient Cristobal Dana Wolf
- Provider
- provider Verónica Delgado
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
016cc0d6-9a88-e8dc-f1c8-1d7b9766ec64