Claim total
$155.66
base $155.66 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 394701000
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2019-06-15
- Stop
- 2019-06-15
The parties
- Patient
- patient Tawanna Nedra Kuhlman
- Provider
- provider Lawrence Lemke
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer UnitedHealthcare
Record id
00508659-1210-a7fa-3638-523cb68605bd