Claim total
$10,713.40
base $155.66 · payer covered $10,663.40
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2023-06-14
- Stop
- 2023-06-14
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-268e-d8af724cd1d7