Claim total
$5,038.15
base $155.66 · payer covered $5,038.15
The visit
- Class
- Ambulatory
- Code
- 371883000
- Reason
- Allergic disposition609328004
- Start
- 2017-05-30
- Stop
- 2017-05-30
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Trinity Mraz
Record id
00cb11fd-f3f7-0950-bac9-e6dee1856383