Claim total
$155.66
base $155.66 · payer covered $120.66
The visit
- Class
- Ambulatory
- Code
- 394701000
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2017-06-28
- Stop
- 2017-06-28
The parties
- Patient
- patient Ramona Schinner
- Provider
- provider Leta Sipes
- Payer
- payer Dual Eligible
Record id
032000cf-30b4-7e9b-9ea5-d2c539a46b3c