Claim total
$1,121.81
base $93.39 · payer covered $1,071.81
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 2004-07-15
- Stop
- 2004-07-16
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-f6ff-713065f9bb6c