Claim total
$504.69
base $93.39 · payer covered $403.75
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 1965-11-27
- Stop
- 1965-11-27
The parties
- Patient
- patient Donita Kasandra Crooks
- Provider
- provider Lawrence Lemke
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
277f7208-da9a-7c08-f6d2-c87b22ba6dee