Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2015-06-20
- Stop
- 2015-06-20
The parties
- Patient
- patient Philip Allan Watsica
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
2dcab3fc-d581-a646-4f66-c30a6cc85af7