Claim total
$219.95
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 1998-12-26
- Stop
- 1998-12-26
The parties
- Patient
- patient Raven Julieta Johnson
- Provider
- provider Saundra Heller
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
1c0fdca8-d5a1-2af7-7576-ddc2645031b2