Claim total
$6,151.42
base $155.66 · payer covered $6,151.42
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 1992-09-10
- Stop
- 1992-09-10
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-4e2b-c51b3fb66206