Claim total
$504.69
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Dependent drug abuse6525002
- Start
- 2017-09-21
- Stop
- 2017-09-21
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
04384da7-7311-e99a-76ab-a64272472daa