Claim total
$926.42
base $93.39 · payer covered $876.42
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute viral pharyngitis195662009
- Start
- 2024-03-16
- Stop
- 2024-03-16
The parties
- Patient
- patient Cristobal Dana Wolf
- Provider
- provider Goldie O'Hara
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
016cc0d6-9a88-e8dc-3dba-685bb7a5f109