Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Lupus erythematosus200936003
- Start
- 2024-05-18
- Stop
- 2024-05-18
The parties
- Patient
- patient Dora Violet Okuneva
- Provider
- provider Mao O'Keefe
- Payer
- payer Anthem
Record id
001727b6-dbde-2493-1a45-5f9b98498c7a