Claim total
$566.96
base $155.66 · payer covered $516.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2000-03-22
- Stop
- 2000-03-22
The parties
- Patient
- patient Scott Emelina Fisher
- Provider
- provider Darline Franecki
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
3876b3a4-351a-6d35-2ca3-587a63f00dbb