Claim total
$1,120.31
base $93.39 · payer covered $1,070.31
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 2004-11-11
- Stop
- 2004-11-11
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Roxann Nitzsche
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
01bbe7d1-151b-3eec-692c-3057868b958a