Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2017-12-03
- Stop
- 2017-12-03
The parties
- Patient
- patient Lonna Shaina Lang
- Provider
- provider Boris Lynch
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
333a9dcf-5fad-a3e0-67ae-52cf7a28fb84