Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Atopic dermatitis24079001
- Start
- 1987-07-20
- Stop
- 1987-07-20
The parties
- Patient
- patient Josefina Amanda Kuhic
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
28281b8c-b6b1-f0a9-52d1-9d47e06bdeb6