Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1992-04-09
- Stop
- 1992-04-09
The parties
- Patient
- patient Guadalupe Shad Daniel
- Provider
- provider Catalina Weimann
- Care site
- care site MERCY HOSPITAL
- Payer
- payer Medicaid
Record id
0a20b931-ad32-e940-3ab5-536a27927fe7