Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185345009
- Reason
- diagnosis concept Otitis media65363002
- Start
- 2020-04-25
- Stop
- 2020-04-25
The parties
- Patient
- patient Kaycee Luanne Mohr
- Provider
- provider Rebeca Lomeli
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer No insurance
Record id
03ac889d-2da8-a492-dcca-6da959f3530f