Claim total
$504.69
base $93.39 · payer covered $403.75
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2011-11-14
- Stop
- 2011-11-14
The parties
- Patient
- patient Latesha Olimpia Price
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicare
Record id
336a367a-9ecd-f668-d69f-ea71fe2be212