Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2007-08-17
- Stop
- 2007-08-17
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-10fa-7d1b596ff28b