Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1989-09-26
- Stop
- 1989-09-26
The parties
- Patient
- patient Delois Misti Kassulke
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
338d8130-ed7a-f2fb-990f-aea4f286f1c6