Claim total
$101.32
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Acute bacterial sinusitis75498004
- Start
- 1973-09-03
- Stop
- 1973-09-03
The parties
- Patient
- patient Blake Rudolph Von
- Provider
- provider Richard Ledner
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
01986319-54e6-598a-90de-aa2ec99b8bcb