Claim total
$5,038.15
base $155.66 · payer covered $4,988.15
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2023-10-19
- Stop
- 2023-10-19
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-1ea6-4ea19e6a0d94