Claim total
$155.66
base $155.66 · payer covered $5.66
The visit
- Class
- Ambulatory
- Code
- 394701000
- Reason
- diagnosis concept Asthma195967001
- Start
- 2024-03-20
- Stop
- 2024-03-20
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Irmgard Padberg
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-1dee-a635e17ca8bb