Claim total
$566.96
base $155.66 · payer covered $416.96
The visit
- Class
- Ambulatory
- Code
- 170837001
- Reason
- Allergic disposition609328004
- Start
- 2014-03-09
- Stop
- 2014-03-09
The parties
- Patient
- patient Dorsey Kuhic
- Provider
- provider Silvana Weber
- Care site
- care site FAIRVIEW RIDGES HOSPITAL
- Payer
- payer Medicaid
Record id
3ac60cc0-6d0a-3f39-a7ef-857774a8fbc8