Claim total
$1,668.75
base $93.39 · payer covered $1,618.75
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 2006-06-22
- Stop
- 2006-06-22
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-9268-8261d8a6e25d