Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1975-04-12
- Stop
- 1975-04-12
The parties
- Patient
- patient Soledad Sabina Stanton
- Provider
- provider Yasmine Shanahan
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
1a03711e-49e9-4b79-73c5-1569d660afc9