Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185349003
- Reason
- diagnosis concept Epidermal burn of skin403190006
- Start
- 2018-09-20
- Stop
- 2018-09-20
The parties
- Patient
- patient Louella Roberts
- Provider
- provider Harold Hagenes
- Payer
- payer Medicaid
Record id
05092f50-4c35-2d72-f6b8-41a1d8815fdc