Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Child attention deficit disorder192127007
- Start
- 2022-04-06
- Stop
- 2022-04-06
The parties
- Patient
- patient Federico Carroll Grady
- Provider
- provider Lynelle Ankunding
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
0d96c26e-79fa-1a73-51a2-e250128dc437