Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 1968-01-08
- Stop
- 1968-01-08
The parties
- Patient
- patient Delois Misti Kassulke
- Provider
- provider Leta Sipes
- Payer
- payer Medicaid
Record id
338d8130-ed7a-f2fb-3998-f1f1b4d42624