Claim total
$1,074.44
base $93.39 · payer covered $1,024.44
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept End-stage renal disease46177005
- Start
- 2007-01-16
- Stop
- 2007-01-16
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-f4cf-280b81422a7d