Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1985-05-09
- Stop
- 1985-05-09
The parties
- Patient
- patient Carolee Keith Collins
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1b67e981-d188-cc73-965e-1b778932b32a