Claim total
$1,168.10
base $155.66 · payer covered $934.47
The visit
- Class
- Ambulatory
- Code
- 439740005
- Reason
- diagnosis concept History of renal transplant161665007
- Start
- 2004-01-21
- Stop
- 2004-01-21
The parties
- Patient
- patient Donny Wilfred Ruecker
- Provider
- provider Hazel Effertz
- Payer
- payer Medicare
Record id
0054427e-44d7-94b2-a5cc-50160cab6c36