Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 1977-03-29
- Stop
- 1977-03-29
The parties
- Patient
- patient Titus Robin Padberg
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
37c88daa-2e1a-b14a-45cc-a6475f74d382