Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185347001
- Reason
- Allergic disposition609328004
- Start
- 2008-10-09
- Stop
- 2008-10-09
The parties
- Patient
- patient Debbi Steven McLaughlin
- Provider
- provider Rebeca Lomeli
- Care site
- care site FAIRVIEW SOUTHDALE HOSPITAL
- Payer
- payer Medicaid
Record id
358791ea-ef95-e7ec-886b-acaa6a3f2839