Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Cow's milk3718001
- Start
- 2005-11-27
- Stop
- 2005-11-27
The parties
- Patient
- patient Lonna Shaina Lang
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
333a9dcf-5fad-a3e0-befe-75bc64c3d4ba