Claim total
$1,168.10
base $155.66 · payer covered $934.47
The visit
- Class
- Ambulatory
- Code
- 439740005
- Reason
- diagnosis concept History of renal transplant161665007
- Start
- 2011-12-04
- Stop
- 2011-12-04
The parties
- Patient
- patient Lesia Catalina Ledner
- Provider
- provider Brian Gleason
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Medicare
Record id
058279b6-7701-4823-ed92-5c7fcb360f5f