Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1997-04-19
- Stop
- 1997-04-19
The parties
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
021142be-3a32-af72-a480-f9569c563ffb