Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Atopic dermatitis24079001
- Start
- 1971-04-11
- Stop
- 1971-04-12
The parties
- Patient
- patient Rodolfo Cesar Cartwright
- Provider
- provider Jack Boehm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
1c95d9b2-6189-e9d5-693c-a05de19fc190