Claim total
$219.95
base $93.39 · payer covered $184.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 2014-03-18
- Stop
- 2014-03-18
The parties
- Patient
- patient Lacy Schumm
- Provider
- provider Hazel Effertz
- Payer
- payer Dual Eligible
Record id
1b98fd26-00a1-c39a-15f7-460a43f8ba4c