Claim total
$93.39
base $93.39 · payer covered $43.39
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Cow's milk3718001
- Start
- 1983-07-10
- Stop
- 1983-07-10
The parties
- Patient
- patient Demetrius Kellye Brown
- Provider
- provider Enoch Torp
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
34d00a16-aef5-c007-f739-6befafa3d21f