Claim total
$715.06
base $93.39 · payer covered $680.06
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 1993-10-13
- Stop
- 1993-10-13
The parties
- Patient
- patient Morris Hartmann
- Provider
- provider Criselda Bartell
- Payer
- payer Dual Eligible
Record id
36a22334-42e4-d3c9-3f58-d04863c49933