Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Atopic dermatitis24079001
- Start
- 1964-09-18
- Stop
- 1964-09-18
The parties
- Patient
- patient Mariana Ana Ornelas
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
11444f3f-edac-88ba-013b-bcc651672f3f