Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Child attention deficit disorder192127007
- Start
- 2018-07-22
- Stop
- 2018-07-22
The parties
- Patient
- patient Shane Ulysses Corwin
- Provider
- provider Lonnie Dietrich
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
10fe28ac-fc4b-0361-d534-1b7087904ba6