Claim total
$504.69
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 1983-12-12
- Stop
- 1983-12-12
The parties
- Patient
- patient Lincoln Jamison Bernier
- Provider
- provider Valene O'Conner
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Humana
Record id
0ff41c86-4494-9e52-7dd5-ef793ad8b53a