Claim total
$127.17
base $127.17 · payer covered $0.00
The visit
- Class
- Inpatient
- Code
- 56876005
- Reason
- diagnosis concept Dependent drug abuse6525002
- Start
- 2004-06-25
- Stop
- 2004-07-04
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Liane Wehner
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
04384da7-7311-e99a-9cb9-8519d3a7ac15