Claim total
$504.69
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1975-12-19
- Stop
- 1975-12-19
The parties
- Patient
- patient Bambi Margareta Davis
- Provider
- provider Kiyoko Predovic
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer No insurance
Record id
157dfde4-08b5-f812-2fe1-07e0c979c018