Claim total
$504.69
base $93.39 · payer covered $454.69
The visit
- Class
- Ambulatory
- Code
- 185345009
- Reason
- diagnosis concept Childhood asthma233678006
- Start
- 2007-11-01
- Stop
- 2007-11-01
The parties
- Patient
- patient Ashly Leighann Feest
- Provider
- provider Kristofer White
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicaid
Record id
38cad737-c721-1ba3-90c9-a6f52ba4353a