Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2004-01-16
- Stop
- 2004-01-16
The parties
- Patient
- patient Benton Terrance Mills
- Provider
- provider Michael Dibbert
- Payer
- payer Medicaid
Record id
2549a80c-7eed-22f1-c302-dfc07a078e85