Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Atopic dermatitis24079001
- Start
- 2025-06-12
- Stop
- 2025-06-12
The parties
- Patient
- patient Coretta Philomena Boyle
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
06293262-0c72-c029-9c9a-7abbfb130ddb