Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 1999-10-19
- Stop
- 1999-10-19
The parties
- Patient
- patient Rosario Lucia Avilés
- Provider
- provider Rosina Schaden
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
199a763e-853b-2729-2a51-252673cdfdaf