Claim total
$8,910.27
base $155.66 · payer covered $8,860.27
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2025-07-15
- Stop
- 2025-07-15
The parties
- Patient
- patient Cristobal Dana Wolf
- Provider
- provider Richard Ledner
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
016cc0d6-9a88-e8dc-a9f0-a7ef4e487317