Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1988-06-19
- Stop
- 1988-06-19
The parties
- Patient
- patient Christian Gustavo Ortiz
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
3007672f-4e3e-4556-5fe6-c9903ac9ba95