Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2002-06-01
- Stop
- 2002-06-01
The parties
- Patient
- patient Joye Rebecka Rutherford
- Provider
- provider Rudolf Wolff
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
3664ee73-1dd3-5502-b5a2-f6f48378fde0