Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2000-07-23
- Stop
- 2000-07-23
The parties
- Patient
- patient Victor Denis Cole
- Provider
- provider Rebeca Lomeli
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
1fe76002-6b9a-6bae-208e-7e95fa6a33f5