Claim total
$93.39
base $93.39 · payer covered $0.00
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- diagnosis concept Atopic dermatitis24079001
- Start
- 2007-11-25
- Stop
- 2007-11-25
The parties
- Patient
- patient Latesha Olimpia Price
- Provider
- provider Arie Bruen
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Aetna
Record id
336a367a-9ecd-f668-898c-0e34a7010ce0