Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Major depressive disorder370143000
- Start
- 1989-05-03
- Stop
- 1989-05-03
The parties
- Patient
- patient Waltraud Lily Yundt
- Provider
- provider Cheryll Willms
- Payer
- payer Medicaid
Record id
1f58a428-477a-27c1-d7dd-2e380265e032