Claim total
$219.95
base $93.39 · payer covered $169.95
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Chronic kidney disease stage 4431857002
- Start
- 1989-09-19
- Stop
- 1989-09-19
The parties
- Patient
- patient Vito Nolan Bruen
- Provider
- provider Lazaro Schumm
- Care site
- care site ALLINA HEALTH SYSTEM
- Payer
- payer Medicaid
Record id
280b537b-944a-b81c-bb47-5a1d3a5f91ad