Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2006-09-08
- Stop
- 2006-09-08
The parties
- Patient
- patient Bennie Breitenberg
- Provider
- provider Janette Fisher
- Payer
- payer Medicaid
Record id
387f90ae-8393-d71f-bcfb-6376a3ed895d