Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2005-07-13
- Stop
- 2005-07-13
The parties
- Patient
- patient Dorsey Kuhic
- Provider
- provider Charlie Tillman
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
3ac60cc0-6d0a-3f39-1b5c-6503de550423