Claim total
$6,986.91
base $155.66 · payer covered $6,936.91
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2026-09-06
- Stop
- 2026-09-06
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-4bc8-874967744c0e