Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Contact dermatitis40275004
- Start
- 2010-08-19
- Stop
- 2010-08-19
The parties
- Patient
- patient Jeremy Gregory Jacobson
- Provider
- provider Chance Wisoky
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
Record id
04f9baea-0c64-12b2-51b7-4e3d36e0beac