Claim total
$75.00
base $75.00 · payer covered $0.00
The visit
- Class
- Virtual
- Code
- 185347001
- Reason
- diagnosis concept Contact dermatitis40275004
- Start
- 2022-09-21
- Stop
- 2022-09-21
The parties
- Patient
- patient Sammy Denis Dooley
- Provider
- provider Alden Nienow
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
36a2d409-ef1c-3246-bb74-a35acd3042b5