Claim total
$504.69
base $93.39 · payer covered $469.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 1986-11-18
- Stop
- 1986-11-18
The parties
- Patient
- patient Freddie Eneida Johnston
- Provider
- provider Noe Hills
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Dual Eligible
Record id
266dd9ea-09f0-0693-d2b8-238e35e07580