Claim total
$19,685.62
base $155.66 · payer covered $19,635.62
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2025-03-19
- Stop
- 2025-03-19
The parties
- Patient
- patient Cristobal Dana Wolf
- Provider
- provider Jacquelyne Skiles
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
016cc0d6-9a88-e8dc-fd6b-12c24e8c9335