Claim total
$566.96
base $155.66 · payer covered $516.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2022-03-25
- Stop
- 2022-03-25
The parties
- Patient
- patient Lacy Kattie Cartwright
- Provider
- provider Krystal Strosin
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
10a5a577-972b-49ae-2ec1-aebf1834c86b