Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Atopic dermatitis24079001
- Start
- 1963-06-19
- Stop
- 1963-06-19
The parties
- Patient
- patient Lucia Eloisa Prado
- Provider
- provider Theo Rutherford
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
130f657d-55b9-f148-c5c9-d18bbc6bfd97