Claim total
$127.17
base $127.17 · payer covered $54.34
The visit
- Class
- Inpatient
- Code
- 56876005
- Reason
- diagnosis concept Dependent drug abuse6525002
- Start
- 1993-03-24
- Stop
- 1993-04-22
The parties
- Patient
- patient Ángela Carlota Lovato
- Provider
- provider Liane Wehner
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0465c17f-66cb-2155-311c-b07073dcda1d