Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 1972-05-22
- Stop
- 1972-05-22
The parties
- Patient
- patient Hiram Dillon Lind
- Provider
- provider Adrienne Hills
- Payer
- payer Medicaid
Record id
24c3fed1-e126-e512-0818-ff3ae960a58e