Claim total
$1,168.10
base $155.66 · payer covered $1,168.10
The visit
- Class
- Ambulatory
- Code
- 439740005
- Reason
- diagnosis concept History of renal transplant161665007
- Start
- 2007-05-05
- Stop
- 2007-05-05
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Roxann Nitzsche
- Care site
- care site ALTRU HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
01bbe7d1-151b-3eec-02e2-5e862b3fe013