Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2003-11-26
- Stop
- 2003-11-26
The parties
- Patient
- patient Stuart Bennie Torp
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
12b83633-7c2e-6812-f890-c156c82a08be