Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Seasonal allergic rhinitis367498001
- Start
- 2015-11-24
- Stop
- 2015-11-24
The parties
- Patient
- patient Cristobal Dana Wolf
- Provider
- provider Rudolf Wolff
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
016cc0d6-9a88-e8dc-051b-9cb728e4d09e