Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Contact dermatitis40275004
- Start
- 1993-07-05
- Stop
- 1993-07-05
The parties
- Patient
- patient Cristy Exie Pouros
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
034e20ab-aae7-ddf8-dab8-d9f74e64341a