Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2019-11-04
- Stop
- 2019-11-04
The parties
- Patient
- patient Eduardo Hugo Salas
- Provider
- provider Georgetta Kohler
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
368bd39f-60e1-6930-41ab-600b89c8e373