Claim total
$5,794.74
base $155.66 · payer covered $5,794.74
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2017-02-01
- Stop
- 2017-02-01
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Leta Sipes
Record id
00cb11fd-f3f7-0950-ae8c-7ed81557867c