Claim total
$5,863.83
base $155.66 · payer covered $4,691.07
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 1990-01-23
- Stop
- 1990-01-23
The parties
- Patient
- patient Lucie Shayla Metz
- Provider
- provider Leonora Bechtelar
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
0095f26f-6c35-6a9c-414c-99d9d897a0ea