Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2021-10-01
- Stop
- 2021-10-01
The parties
- Patient
- patient Andree Marlyn Fisher
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
07dee941-9b7c-029e-e16b-af9100a39b69