Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1984-10-05
- Stop
- 1984-10-05
The parties
- Patient
- patient Dung Roberta Murazik
- Provider
- provider Rebeca Lomeli
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
0b232c0c-cf3d-90c4-6ea3-0c881a6f60ef