Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Outpatient
- Code
- 185345009
- Reason
- diagnosis concept Otitis media65363002
- Start
- 2016-10-20
- Stop
- 2016-10-20
The parties
- Patient
- patient Shalon Arnetta Bosco
- Provider
- provider Pamula Dare
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
03f768f4-038d-f7fd-6ec5-84f65427e8d3