Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Cow's milk3718001
- Start
- 1986-11-26
- Stop
- 1986-11-26
The parties
- Patient
- patient Maia Chelsie Runolfsson
- Provider
- provider Grant Mitchell
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
171169a6-b136-3c65-a1d3-50db909c4f5d