Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 1965-08-09
- Stop
- 1965-08-09
The parties
- Patient
- patient Millie Latrina Franecki
- Provider
- provider Tiffany Smitham
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
293b5046-ff66-69d2-b91f-be872384fff1