Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2025-05-30
- Stop
- 2025-05-30
The parties
- Patient
- patient Tresa Mamie McLaughlin
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
31d89ffd-eb48-8b87-bf36-6bca62a4865e