Claim total
$5,657.91
base $155.66 · payer covered $5,657.91
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2016-12-12
- Stop
- 2016-12-12
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Burton O'Conner
Record id
00cb11fd-f3f7-0950-1035-e4ca85bdfef3