Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Wheat412071004
- Start
- 1997-11-03
- Stop
- 1997-11-03
The parties
- Patient
- patient Chandra Price
- Provider
- provider Rebeca Lomeli
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
178d2332-aca9-7b53-0ef9-4d3524dcd053