Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2013-08-12
- Stop
- 2013-08-12
The parties
- Patient
- patient Kandra Debroah Thiel
- Provider
- provider Edmond Bauch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
25c733b1-fb13-5def-f3fc-918fe23dd6bb