Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2022-03-25
- Stop
- 2022-03-25
The parties
- Patient
- patient Lacy Kattie Cartwright
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
10a5a577-972b-49ae-6a45-a2f94bf25a5d