Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Atopic dermatitis24079001
- Start
- 1999-12-19
- Stop
- 1999-12-19
The parties
- Patient
- patient Adella Mitchell Erdman
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
37dacb37-2dca-f6a0-c20f-b6ad5bc3d5c7