Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Atopic dermatitis24079001
- Start
- 1962-09-04
- Stop
- 1962-09-04
The parties
- Patient
- patient Donita Kasandra Crooks
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Humana
Record id
277f7208-da9a-7c08-f448-0e552c3e8b3d