Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 1973-07-11
- Stop
- 1973-07-11
The parties
- Patient
- patient Travis Reichert
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
0c81d398-2cb2-843e-b647-f852b0c9bbbb