Claim total
$155.66
base $155.66 · payer covered $120.66
The visit
- Class
- Ambulatory
- Code
- 281036007
- Reason
- diagnosis concept Alzheimer's disease26929004
- Start
- 2023-09-14
- Stop
- 2023-09-14
The parties
- Patient
- patient Efren Wilderman
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Dual Eligible
Record id
0400ef40-232f-be7a-098e-acae346e8647