Claim total
$504.69
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 1997-01-21
- Stop
- 1997-01-21
The parties
- Patient
- patient Marshall Rochel Jacobi
- Provider
- provider Lawrence Lemke
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
38cca9f9-b0e8-26ef-899f-6f7d84a6f419