Claim total
$219.95
base $93.39 · payer covered $169.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 1994-06-24
- Stop
- 1994-06-25
The parties
- Patient
- patient Efren Wilderman
- Provider
- provider Saundra Heller
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0400ef40-232f-be7a-4156-925b435e86e4